| tBRAPtY OF CWGRESS. || 

; TATESOFAJ[EJUCA.l 



AN 

EPITOME 



OF THE 



AMERICAN ECLECTIC 



PRACTICE OF MEDICINE: 



EMBRACING 

PATHOLOGY, SYMPTOMATOLOGY, DIAGNOSIS, 
PROGNOSIS, AND TREATMENT. 

CONTAINING, ALSO, 

A COMPLETE LIST OF THE REMEDIES USED BY 

ALLOPATHISTS, HOMCEOPATHISTS, AND 

HYDROPATHISTS, AND AN ECLECTIC 

PHARMACY AND GLOSSARY. 



DESIGNED FOR 

PHYSICIANS, THE STUDENT OF MEDICINE, AND AS A 
DOMESTIC PEACTICE FOR FAMILIES. 



BY 



WILLIAM PAINE, M.D., 

PROFESSOR OF THE PRINCIPLES AND PRACTICE OF MEDICINE AND PATHOLOGY 
IN THE ECLECTIC MEDICAL COLLEGE OF PENNSYLVANIA, PIHLA. 



51 

EETH^ 
185T 







Entered, according to Act of Congress, in the year 1857, by 

WILLIAM PAINE, 

in the Clerk's Office of the District Court of the United States for the Eastern 
District of Pennsylvania. 



STEREOTYPED DY J. FAOAX, PHILADELPHIA. 



PRINTED BY BMITH»4 PETEBS, 

Franklin Buildings, Sixth Street, below Arch, 

Philadelphia. 



TO MY COLLEAGUES, 

PROFESSORS CHASE, SITES, HOLLIMBAU, CALKINS, AND HOLLAND, 

IX CONSIDERATION OF THEIR 

EARNEST EFFORTS IX THE CAUSE OF 

MEDICAL PROGRESS, 

THIS WORK 

£s ^vcs^cctxullD E-nacvifoefi bv 

THE AUTHOR. 



(iii) 



LIST OF SOME OF THE PRINCIPAL AUTHORS 
REFERRED TO IN THE PREPARATION OF 
THIS WORK. 



TriE American Eclectic Practice of Medicine, by Jones and 
Morrow; The Eclectic Practice of Medicine, by Newton and 
Powel; Newton and Calkins' Work on Thoracic Diseases; Ameri- 
can Eclectic Dispensatory, by John King, M. D. ; The Eclectic 
Medical Journal; Middle States' Medical Reformer ; The College 
Journal of Medical Science ; The Worcester Journal of Medi- 
cine ; The Syracuse Medical and Surgical Journal ; Massie's 
Eclectic Practice ; Fondey on Tuberculous and Scrofulous Dis- 
eases ; Dickson on Chronothermalism ; Eberle's Practice of 
Medicine ; Clymer on Fevers ; Boisseau on Fevers ; Craigie on 
Pathology ; Andral on the Abdomen ; Taylor's Medical Juris- 
prudence ; Dunglison on New Remedies ; Mcintosh's Practice 
of Medicine ; Lehmann's Chemical Physiology ; Simon's Che- 
mistry of Man ; Renouard's History of Medicine ; Jahr and 
Grnner's Homoeopathic Pharmacopoeia; Hull and Laurie's 
Homoeopathic Practice ; Pulte's Homoeopathic Practice ; Jahr's 
Manual of Homoeopathy ; Hydropathic Encyclopedia, by Dr. 
Trail ; Walsh on Diseases of the Lungs and Heart ; American 
Eclectic Obstetrics, by John King, M. D. ; American Journal 
of Medical Science ; Carpenter's Physiology ; Family Medical 
Library, by William Buchan. 



(iv) 



PREFACE. 



This volume presents an Epitome of the Ameri- 
can Eclectic Practice of Medicixe. It is designed 
as a note-book for the profession, in which, is re- 
corded many valuable facts relative to the prin- 
ciples and practice of medicine, and as an assistant 
to the student in his medical acquirements; also, 
as a guide to domestic practice for families. My 
object, in the preparation of this work, has been to 
record, in a condensed form, what I conceive to be 
true relative to the present condition of practical 
medicine, and to give the American Eclectic Treat- 
ment of disease, which has proved so signally suc- 
cessful in my hands. Also to enable the public to 
judge more correctly of the respective merits of 
the different systems of medicine. 

To accomplish this, I have referred to standard 
works of Allopathy, Homoeopathy, and Hydro- 
pathy ; and, in each case, have given the author's 
own words. The object of this was to allow each 
1* (v) 



VI PREFACE. 

medical system to explain its own position. I 
have also given, in a condensed form, the character- 
istic symptoms of most of the diseases peculiar to 
this country, as manifested during their progress. 
The practical part of the work has been prepared 
with especial care, that it might serve as a safe 
and efficient guide, to the profession and the public, 
for the speedy removal of disease; and if this 
volume contributes, in any essential degree, to 
alleviate human suffering, and to advance the 
cause of true medical science, I shall feel myself 
measurably compensated for the arduous task of 
preparing it. 

THE AUTHOR. 



PEACTICAL PEINCIPLES 



AMERICAN ECLECTIC SYSTEM OF MEDICINE. 



In endeavoring to lay down some of the principles "which 
form a basis to the American Eclectic System of Medicine, it 
would be presumption, in me, to attempt to do more here than 
give an outline of what we consider to be the true principles 
which govern the great American movement for reforming the 
medical profession. Before entering upon a discussion of these 
principles, however, I cannot refrain from stating what I con- 
ceive to be true relative to the present condition of the healing 
art. 

1st. That a large majority of cases treated by all classes of 
physicians, are cured by nature and not by medicine. 

2d. That in many cases nature removes the disease in spite 
of medicine. 

3d. That many fatal cases would have recovered, were it not 
for medical interference. 

4th. That the Allopathic practice of treating cases by mer- 
cury, blisters, antimony, blood-letting, &c, is so far from saving 
life as to be absolutely a prolific source of disease and death. 

5th. That the homoeopathic practice of saturating the system 
with small doses of arsenic, mercury, dog-button, antimony, 
lachesis, &c, although the effects are not as immediate as when 
taken in large doses, yet in their tendency to derange the blood, 
and lay the foundation for scrofula, consumption, dropsy, dis- 
ease of the stomach, liver, and uterus, with other diseases of a 
fatal character, makes this practice equally disastrous to health 
and life. 

(<; 



8 PRACTICAL PRINCIPLES. 

6th. That, although hydropathy is frequently a valuable 
auxiliary in the treatment of disease, yet, when unskilfully 
and untimely applied, it becomes an additional cause of sick- 
ness and death. 

7th. That the entire catalogue of patent medicines are pro- 
ductive of an immense amount of disease, suffering and death. 

8th. That advertising physicians, such as Analytic, Uriscopian, 
cancer doctors, &c, together with the entire herd of nostrum 
venders, are only so many professional knaves, who defraud the 
people of their money, their health, and their lives. 

9th. That although the American Eclectic System has for its 
object and aim the correction of the abuses of the profession, 
as well as the determinate purpose to prevent the administration 
of medicines fraught with evil tendencies to life or health, yet 
from ignorance, or other cause, the medicines may be improperly 
administered, and thereby lessen the chances of recovery. 

In making these statements, I do not wish to be understood to 
deny the power of medicine over disease when properly admin- 
istered, neither would I say that Allopathy, Homoeopathy, &c, 
are never employed with benefit to the afflicted. But as prac- 
tised by a large majority of that class of physicians, who are 
ignorant of the true nature of disease, as well as the correct 
principles of cure, they are infinitely more injurious than 
beneficial. 

This class of practitioners, to shield their ignorance, attack, 
in the most vehement manner, every improvement in the pro- 
fession which in the least conflicts with their narrow and 
illiberal views. It is this class of the profession who have 
contributed so largely, to the persecution of every attempted 
improvement in the practice, and unfortunately they have 
always been sufficiently numerous to control, in a great measure, 
its destiny. Thus while every other branch of physical science 
has made gigantic strides, the progress of medical science has 
been comparatively slow. While Geology has explored the 
earth from centre to circumference, and reads, from every tablet, 
the mighty creative power of Him who has thus wonderfully con- 
structed it; while Astronomy not only encircles this solar 
system, but gazes beyond, upon millions of suns and adaman- 
tine spheres that wheel unshaken through the immensity of space; 



PRACTICAL PRINCIPLES. 9 

while Chemistry has analyzed and explained nearly every 
animal, vegetable, and mineral substance; while Zoology and 
Botany give unmistakable evidence of uninterrupted progress ; 
while, by the endless variety of labor-saving machinery, the 
improved method of printing, the transmission of thought with 
lightning speed to earth's extreme, the iron horse which break- 
fasts in the valley of the Mississippi, dines upon the rocky 
Alle^hanies, and sups on the borders of the Atlantic, with other 
innumerable inventions, show that the arts, in progress and 
improvement, keep pace with the march of time ; while the 
powerful engines of Christian fidelity have burst the bonds of 
Catholicism, and unfurled the banner of religious liberty, which, 
for more than three centuries, has floated high in the pure breeze 
of Christian freedom ; while also the improvement in the moral 
condition of mankind is seen in the glorious works of reforma- 
tion, which are so zealously carried on ; while such extensive 
progress has been made to the perfection of art and every other 
department of science, it will be seen by reference to fact, that 
every attempt to improve the healing art, has met such bitter 
opposition ; that, comparatively, its progress has been slow, and 
it is far from occupying that advanced position in the ranks of 
science which its importance demands. 

Harvey, who discovered the circulation of the blood, was called 
the circulator, in derision. He was deprived of the right to practise 
his profession in his own country; was threatened with banish- 
ment, and finally was compelled to leave his native land, to 
escape the obloquy that was heaped upon him, and died with- 
out realizing the benefit of his labors. 

In 1522, Ambrose Pare first introduced the ligature, and tied 
the artery, instead of plunging the limb into boiling tar, as was 
practised by his cotemporaries. He was denounced, with the 
most reckless violence, for daring to suspend the life of a man 
upon a mere thread. In 1638, the Countess of Cinchon, wife of 
the ex-king of Peru, was laboring under a fever, from which 
she was unable to obtain relief. The Governor of Loxa, having 
learned from the natives the curative powers of the Cinchona, 
advised her to employ it. After much hesitation, she resolved 
to try it, and was by its use restored to health. Ten years 
afterwards, a Jesuit of Rome endeavored to introduce the Peru- 



10 PRACTICAL PRINCIPLES. 

vian Bark into Europe ; but his efforts were unsuccessful. The 
profession proclaimed at once that it was a Papish remedy, and 
proceeded from Quacks, who created all manner of disease. 
Protestant England called it a Papish remedy, saying that it 
proceeded from the father of all Papists, the Devil. It was not, 
until in spite of all opposition, its utility was demonstrated, 
that physicians availed themselves of its curative powers. 

Lady Mary Wortley Montague, while in Turkey, observing 
the wonderful effect of inoculation for small-pox, to mitigate the 
severity of that much dreaded disease, determined to introduce 
the practice into her native country. But no sooner did she make 
known her purpose, than the medical faculty arose at once and 
predicted the most disastrous consequences. The clergy de- 
scanted from the pulpit on thus seeking to take events from the 
hand of Providence. In order to satisfy the profession and the 
people of the great utility of inoculation, she resolved to experi- 
ment upon her own daughter, and government appointed four 
of the best medical men to observe its progress. Lady Montague 
states, that they not only manifested the greatest incredulity as 
to its success, but also such an unwillingness to have it succeed, 
that she was absolutely afraid to leave her daughter in their 
hands, lest she should suffer from their interference. 

In 1790, Dr. Jenner, of Gloucester, remarked that the disease 
known in the western part of England as cow-pox, communi- 
cated to those who milked the cows, precluded those who became 
thus affected from being infected with small-pox. This strange 
fact suggested to him the idea of inoculating children with 
virus directly from the udder of the cow, which he accord- 
ingly did, and in the course of four or five days he saw pustules 
developed at all points where the skin had been punctured, 
similar to those of cow-pox ; when the pustule broke, the pus 
dried, forming a thin scale or crust, which, falling off, left a 
cicatrice. There was little or no fever, the children continuing 
to eat and play as usual. After repeated experiments of this 
kind, Dr. Jenner became satisfied of its being a preventive of 
small-pox, as not a single child thus inoculated was attacked 
with it. But how was the discovery received by the illiberal 
and dogmatical portion of the profession ? With ridicule and 
contempt, like every other proposed improvement. Jenner was 



PRACTICAL PRINCIPLES. 11 

persecuted, oppressed, and driven from his country ; even re* 
ligion and the Bible were made engines of attack against him 
and his invention. Errhman, of Frankfort, attempted to prove 
from Scripture that vaccination was the anti-Christ. At that 
time small-pox was the scourge of the human family, and, but 
for the discovery of Jenner, would have remained such until the 
present time. 

In 1315, Mondini dissected two human bodies, and shortly 
after published his Epitome of Anatomy, illustrated with wood- 
cuts. At this time, and for a long time afterward, it was cus- 
tomary to demonstrate anatomy upon the hog and other animals. 
The act of Mondini was considered heresy. The persecution 
of Mondini, together with the prejudice existing upon the sub- 
ject at the time, prevented any other dissection of a human 
subject for more than a century ; and Mondini, in his experi- 
ments, dared not open the dead for fear of committing a mortal 
sin. It was not until the commencement of the sixteenth 
century that dissections for anatomical purposes were made, 
and then they were performed by the authority of the Pope, and 
not at the instigation of the medical profession. 

The natives of Brazil first taught the medicinal qualities of 
ipecac; but, owing to the opposition with which it was met by 
the medical profession, it was more than a quarter of a century 
before its virtues were appreciated. A Mexican soldier, more 
than half a century ago, demonstrated the styptic properties of 
the Matico, and its entire control over the bleeding vessels of 
the body ; but such is the tendency to oppose every new remedy 
that, as yet, it is never employed by the mass of the profession. 
Dr. Samuel Thomson discovered and proved the valuable 
medical properties of Lobelia; but on modestly making known 
his discovery to the profession, it was not only denounced, but 
he was persecuted and imprisoned. At this time we find 
medical men using it in disguise, and at the same time denounc- 
ing its discoverer. In 1823, an association of scientific medical 
men, from different parts of the country, met in New York city, 
and made preparation for organizing a reform medical college ; 
when, by the indomitable energy of Dr. Beach, the first reform 
medical college in the world was organized. 

The object of this organization was to break the shackles of 



12 PRACTICAL PRINCIPLES. 

Hunkerism ; to open the science of medicine to all bold and 
thorough investigators ; to enlarge and improve the materia 
medica ; to investigate more fully and clearly the nature and 
character of disease peculiar to the country and climate, and 
to place the entire profession upon a more liberal and scientific 
basis. But no sooner was the object and aim of this institution 
announced, than a majority of the profession commenced an 
attack upon it, denouncing, violently, all who were indentified 
with this philanthropic movement. Dr. Beach, its founder, 
although, a man of learning, and a graduate of one of the first 
allopathic colleges in the country, was assailed with terms of 
insolence and reproach, and all those who had the courage to 
participate in the work shared the same fate. To all who are 
in any considerable degree acquainted with the history of 
medicine, it is obvious that this conservatism, which has long 
been a characteristic of the professon, has had a most disastrous 
influence upon its progress. 

The conservative, always ready to apologize and explain the 
reasons for his ungenerous course, with all complacency affirms 
that to talk of improvement is but a dream ; that the fathers of 
the profession have left us their knowledge as a choice legacy, 
which we should keep in grateful remembrance ; that the pro- 
fession has already attained a position which entitles it to the 
highest respect. 

Yet the positive uncertainty of medicines is manifested in a 
striking degree, as we trace the history of particular remedies, 
recommended by those who are reverenced as almost divine 
authority by the conservative. What differences of opinion — 
what an array of alleged facts directly at variance with each 
other — what opposite results of like experience — what ups and 
downs, glorifications and degradation, confidence and despair — 
arose in treating the same disease with the same remedies. To 
be satisfied upon this point we ne§d only refer to the history of 
one or two prominent diseases, viz : pneumonia and syphilis. 
Mercury, antimony and blood-letting have been regarded as 
specifics in these diseases by many authors, while others of equal 
pedantry and learning have rejected them as useless and injuri- 
ous. Such has been the uncertainty of practical medicine, that 
even the conservative portion of the profession, if they become 



PRACTICAL PRINCIPLES. 13 

in the least enlightened, omit the heroic and adopt the expect- 
ant or tentative mode of practice. The foregoing facts disclose 
a lamentable state of things, but not a state to be despaired of; 
*fruch less is it one to be concealed. It is our duty as guardians 
of the lives and health of our fellow-beings, to unmask, not only 
the virtues, but the faults of the profession. The course of our 
subject "will now lead us to attempt to disclose in what the de- 
fects of the allopathic system of practice mainly consist ; the 
cause of these, and the means which seem best calculated to 
remove them. Also the principles which govern the Young 
American Physic. In order to fully understand why the allo- 
pathic system of practice is not more successful in removing 
disease, it will be necessary to enter more fully into its princi- 
ples of cure and therapeutic resources. For the investigation of 
these, it will be necessary to enter somewhat into the history of 
medicine. Pliny states that, if there exist any nation in which 
at any epoch of its history physicians were not found, there 
is none in which traces of medicine were not visible. It is pro- 
bable that medicine has existed, either as an art or science, 
from tha earliest period ; and that the practice of medicine had 
its existence in the natural tendency of the soul to resist death, 
together with benevolent impulses towards the sufferings of 
others. 

The earliest and most authentic account we have of the 
practice of medicine, is that given of Centaur Chiron, a prince 
of Thessaly, who went out in the expedition against Troy. From 
all accounts we have of his practice, it was exceedingly empirical, 
and consisted in the external application of a few remedies to 
wounds, &c, together with incantations and ceremonies to affect 
the imagination. Chiron transmitted his profession, according 
to custom, to his son iEsculapius, and iEsculapius to his two 
sons, Machaon and Podalirius. 

Fifty years after the destruction of Troy, a temple was 
erected at Titan as, a city of the Peloponnesus, in honor of 
iEsculapius, who was worshipped as a god. The worship of this 
god very soon spread throughout Greece and passed into Asia, 
Africa, and Italy. Multitudes of temples were consecrated to 
him, among which those at Epidaurus in the Peloponnesus, at 
Pergamos in Asia, on the island of Cos, and at Cyrene, a city 



14 PRACTICAL PRINCIPLES. 

of Libya, were particularly famous. In the temple at Epidaumus 
there was a statue of colossal size representing the god of 
medicine, under the figure of an old man, seated on a throne, 
holding in one hand a sceptre, and resting the other on the head 
of a large serpent ; a dog, the emblem of vigilance, rested at his 
feet. The statue was of gold and ivory, and was the workman- 
ship of Grasymedus. Socrates, it is said, in his last discourse 
with his friends, requested them to offer for him a cock, as a 
sacrifice to iEsculapius ; whence we infer that this bird was 
sacred to the god of medicine. 

The priests attached to this worship were named Asclepiades, 
or descendants of iEsculapius. They regarded all the knowledge, 
relative to disease and medicine, as sacred, their laws forbidding 
it to be revealed to the non-elect, lest their god should be angry ; 
strangers were not admitted to this knowledge until they had 
been subjected to certain ceremonies called the tests of initia- 
tion. 

These temples were erected in the midst of the most delight- 
ful scenery ; no pains were spared to furnish them with the 
most agreeable and healthful diversions ; they breathed a pure 
air, were subjected to a wholesome regimen, and every possible 
means was used to affect the mind and imagination agreeably ; 
thus exercising a healthful and happy influence upon the con- 
stitution. Fasting and prayer were strictly enjoined upon the 
patients, also abstinence and sacrifices, before they were admitted 
to receive the response of the oracle. Those who were benefited 
went to their homes blessing the author of their recovery, and 
those who were not benefited redoubled their efforts to propitiate 
the god in their favor. Besides these means, remedies were used, 
not unlike those now in vogue, consisting in bleeding, purga- 
tives, vomiting, friction, mineral water, &c. 

There existed in the country, about Epidaurus, serpents of a 
yellowish brown color, whose bite was not poisonous, and which 
were easily tamed. 

These were employed by these priest-doctors to more effectually 
impress the minds of their patients with wonder and astonish- 
ment at their supposed power, which, from all accounts, had the 
desired effect. Aurelins Victor relates, that during the year 
350 of the foundation of Rome, that city was scourged by a terrible 



PRACTICAL PRINCIPLES. 15 

pestilence ; the Senate sent six deputies to consult the oracle at 
Epidaurus. 

On arriving at the temple, suddenly an enormous serpent 
issued from beneath the pedestal. The sight of it filled every 
mind with veneration more than with terror. He moved tran- 
quilly through the crowd and entered the vase of the Romans 
in the chamber of Ogulnius, the chief of the ambassadors. The 
serpent was sacredly borne away, and when the ambassador 
was approaching the city of Romulus it sprang into the waves 
and swam to an island in the Tiber, where a temple was imme- 
diately erected to iEsculapius, and the pestilence ceased. 

It can hardly be doubted that the priest-doctors of these 
temples were endowed with strong natural powers of mind ; that 
they understood the influence of mind over matter; and that a 
strong belief in their ability to cure, contributed in a very con- 
siderable degree to their success. The teachings in these 
temples were confined to the family of JEsculapius for some 
eight or nine hundred years. After a time they became more 
general, assuming more of the character of the medical colleges 
of the present day. Their means of teaching was confined 
mostly to tablets hung upon the walls and columns of the 
temples, showing the name of the patient, the disease, and the 
manner in which it was treated. One of these tablets, found on 
the island in the Tiber, the site of the ancien^ iEsculapian 
temple, bears the following inscription in Greek characters : — 
Lately a certain Caius, who was blind, came to consult the 
oracle. The god required that he approach the sacred altar to 
perform certain adorations ; at once he passed from the right to 
the left, and having rested his fingers on the altar, he raised his 
hands and applied them to his eyes, whereupon he recovered 
his sight immediately in the sight of all the people, who 
rejoiced to see such marvels performed in the reign of our 
august Antoninus. Upon the same tablet is the account of one 
Julin, who had pleurisy, and the gods ordered that the ashes of 
the altar be put into wine and applied to his side, which being 
done, he was immediately cured. Another man, Valerius Aper, 
was blind, and the gods ordered an ointment of the blood of a 
white cock and honey to be applied to his eyes, which was done, 
and his sight restored. The only principle which guides these 



16 PRACTICAL PRINCIPLES. 

priest-doctors in the administration of medicine for the cure of 
disease, was, that remedies, which have once cured, will cure 
again under similar circumstances. 

The practice of medicine, in the temples, was continued until 
about the commencement of the Christian era. Pythagoras, who 
was born in the year 500, B. C, at Samos, one of the most 
flourishing islands in the iEgean sea, having one day heard a 
lecture on the immortality of the soul by Pherecydes, was so 
charmed that he renounced every other occupation to devote 
himself to philosophy. He travelled among the most enlight- 
ened nations, obtaining extensive knowledge in every art and 
science cultivated at that early period, and that of medicine 
among others. It was Pythagoras who first introduced the 
practice of visiting patients in their own houses ; he also 
rejected all theories in medicine, and contended that experience 
was the only safe guide to a successful medical practice. Hip- 
pocrates, who was born on the isle of Cos, 460 B. C, was one 
of the first reformers in medicine we have any account of. He 
was one of the direct descendants of JEsculapius, and received 
his education at Cos, which contained a temple dedicated to 
iEsculapius, and a medical school ; thus his advantages for 
acquiring a medical education were very favorable. He was 
not satisfied, however, with this instruction, and extended his 
researches into the principal Greek cities of Europe and Asia, 
taking a survey of the art of medicine as it then existed, which 
was in a state sadly deficient and imperfect ; the ideas of dis- 
ease, and principles of cure, being of an exceedingly vague and 
uncertain character. He consequently commenced a- series of 
experimental investigations into nearly every department of 
medicine. 

He opened an earnest warfare upon the superstitious cere- 
monies of the JEsculapian priests, and advocated the custom, 
introduced by Pythagoras, of visiting patients at their own 
houses. He also classified and arranged diseases and remedies 
in a much more systematic manner than had hitherto existed, 
and introduced a variety of new remedies, which proved exceed- 
ingly valuable in the treatment of disease. His system of 
Therapeutics was, however, similar to his predecessor; depending 
in his choice of remedies upon those which experimental observ- 



PRACTICAL PRINCIPLES. 1*1 

ation had proved beneficial in removing disease. To show the 
reader how slightly the treatment of disease, twenty-two centuries 
ago, differed from that of a class of practitioners at the present 
time, I will here introduce the treatment for pleurisy, given by 
Hippocrates, as translated by Renouard. 

"It is necessary to examine, in the following manner, the 
peripneumonic and pleuritic affections; if the fever is acute ; if 
there is pain in one or both sides of the chest ; if the patient 
suffers during expiration ; if he coughs, and the expectoration 
is rusty or livid, or thin and frothy, or of a blood-red — if, in 
fine, it differs at all from that which is natural, the following 
course must be pursued : the pain extending above and towards 
the clavicle, or towards the vein and the arm, the internal vein 
of the arm on that side should be opened. The quantity of 
blood drawn should be proportional to the constitution of the 
body, the season of the year, the age and color of the patient ; 
and if the pain is acute, the bleeding should be boldly pushed to 
syncope ; afterward an injection is to be administered. 

" If the pain occupies the inferior region of the chest, and is 
very great, you should prescribe for pleuritics a mild purgation ; 
but the patient must taste nothing else whilst the medicine is 
operating. After the purgation they should have an oxymel.* 
The purgation should not be administered until the fourth day ; 
during the first three days injections should be employed ; but 
if they are not sufficient, the purge should be given, as above 
said. He must be watched until the fever ceases, and the 
seventh day is attained ; after that, if he appears out of danger, 
he may take a little barley-water, sweetened with honey. If the 
convalescence progresses and the respiration is good, the tisane f 
may be given twice a day, and be gradually increased in quan- 
tity and strength ; but if the convalescence is slow the drink 
must be lessened, and a small quantity of weak tisane, for 
nourishment, once a day. It should be given when the patient 
is in the best condition, as may be known by the appearance of 
the urine. 

" To those who approach the close of the disease, it is not 
necessary to give the tisane before you see the coction manifested 
in the urine or expectoration ; nevertheless, if, when purged, the 

* Decoction of barley. f Oxymel, honey and vinegar syrup. 

2* 



18 PRACTICAL PRINCIPLES. 

patient has abundant evacuations, it is necessary to give the 
tisane, but in less quantities and weaker, otherwise the empti- 
ness of the vessels would allow him neither to sleep, nor to 
digest, nor to await the crisis. With this exception, the crude 
humors should be liquefied, and whatever has been the obstacle 
should be ejected : then nothing prevents alimentation. The 
expectoration is perfectly concocted when it appears like pus : 
the urine, also, when it has a red sediment like brick-dust. 

" As to the pain in the side, nothing contra-indicates the uso 
of fomentations and wax-plasters. The legs and arms should 
be rubbed with warm oil and then anointed with fat. The 
hypochondria should be covered as high as the breast with a flax- 
seed poultice. When the peripneumonia has reached its height, 
nothing can be accomplished without purgation : it is bad if the 
patient has dyspnoea, or if the urine be thin and acid, or there 
be sweats around the neck and head. These sweats indicate 
danger in proportion to the violence of the disease, which is 
known by the suffocation and rattling, which increases and 
produces death, unless there supervene an abundant flow of 
viscid urine, or of concocted sputa. Whichever of these two 
phenomena supervenes, it indicates resolution. 

"An eclegma is prescribed for peripneumonia, with galbanum 
and grains of pine seed, in Attic-honey. Other expectorants are 
employed, such as worm-wood (Artemisia dbrotanum, Lin.), and 
pepper in oxymel ; purgatives — boil black hellebore (Helleborus 
orientalis, Lin.), and give it as a drink to pleuritics at the com- 
mencement and while the pain is felt A useful remedy in 
affections of the liver, and in pains proceeding from the 
diaphragm, is a drink of opoponax (Pastinacce ojpoponax, Lin.), 
boiled in oxymel and strained. In general, a remedy that is to 
act on the stools, or urine, should be given in wine and in hone^ ; 
if to act on the stools alone, it should be given in a much larg<r 
quantity of diluted oxymel." 

It will be seen, by comparing the treatment of Hippocrates 
with that of Dr. Eberle, given in another part of this work, that 
there is no essential difference. The bleeding and purgative 
plan is still adhered to. 

At the death of Hippocrates, which occured when he was 
about one hundred years of age, his two sons, Thassalius and 



PRACTICAL PRINCIPLES. 19 

Draco, together with his son-in-law Potybius, cultivated the art 
of medicine, and transmitted the knowledge of their father by 
teaching in a public manner his doctrines. Hippocrates and his 
sons were the first authors of any note upon the subject of medi- 
cine. 

The foundation of the Alexandrian Library, about the year 
320 B. C, had a happy effect upon some departments of medicine, 
as Anatomy, Physiology, &c. 

But from the statement of Galen, who had examined all the 
contents of this library relative to medicine, it appears that the 
only knowledge it evinced of therapeutics was merely experi- 
mental. The Alexandrian Library is said to have contained 
about 600,000 volumes or rolls, which were equal to about 
200,000 modern bound volumes. This library contained all the 
valuable information of those times in every department of 
science and art. It was burnt by Caliph Omar, A. D., 640, who 
gave as his reasons that, if the books agreed with the Koran, they 
were of no use, and if they disagreed they contained heresy, 
and should be burnt. Thus far in the history of medicine, the 
only therapeutic axiom was this : "When a treatment was suc- 
cessful in one case, it was always employed in analogous cases 
without inquiry whether it acted upon one principle or another ; 
although Hippocrates and his disciples suggested some diseases 
were cured by their opposites, and others by similars ; while 
again diseases have been cured by remedies which appear to be 
neither similar nor contrary to the nature of the disease. 

It is not my purpose to enter in any considerable degree into 
the consideration of the theories which prevailed in those ancient 
times relative to disease, yet I can hardly present to the reader 
any thing like an idea of the comparative condition of medicine, 
without noticing in a brief manner some of the more prominent 
notions relating to it. The xlsclepiades, of the isle of Cos, regarded 
disease as a series of phenomena, resulting from the efforts of 
nature to remove the cause of the disease. They regarded nature 
as competent to accomplish her purpose in many instances, but in 
others medical interference become necessary. They also 
regarded disease as having critical days and a certain duration. 
Pythagoras states that the number of days which bring about 
the cure or death of a patient, regulates the crisis, of fevers. In 



20 PRACTICAL PRINCIPLES. 

remarking upon the observation of these critical periods and 
daily phenomena of disease, he says that a physician who 
neglects nothing that may contribute to the patient's health, 
must observe carefully what passes each day. 

Among those days of even numbers the most important are 
the fourteenth, the twenty-eighth, and the forty-second. Who- 
ever carefully observes the phenomena of disease, as described 
by these ancient authorities, will see an aphorism of Prof. J. J. 
Jones verified: That all diseases are more or less periodic. 
Following the doctrine of crisis is that of the four elements, 
Heat, Cold, Dryness and Moisture ; and the four cardinal humors, 
blood, bile, atra-bile, and phlegm. 

Empedocles was the first to introduce this doctrine of the 
elements. He says the human body is composed of blood, 
phlegm, and two sorts of bile — yellow and black; and that 
their condition determines the state of health ; that perfect 
health consists in a due proportion of each ; that disease is 
caused by an excess of any one of these, or if any one lacks its 
due proportion, or is evacuated without being properly mixed — 
for when it is thus evacuated, they claim that not only the 
region where the admixture took place must be affected, but the 
organ, through which it passed off, must suffer and become dis- 
eased. Another theory of those times was, that all disease was 
caused by cold, which they explained as follows : — Colds cause 
the condensation of the tissues and veins of the head ; if the 
cold strikes them when they are heated, they contract, and the 
humors contained in them are expelled. All the tissues are 
obliged to pour out their fluids when they contract. 

Fluxions are also caused by the tissues becoming heated, 
which rarefies them, enlarges their pores ; the humors they con- 
tain are attenuated, so that it flows easily when compressed. 
This theory of fluxions is regarded as being anterior to Hippo- 
crates. For a long time after Hippocrates, we have no writings 
from which we can learn any progress in the practical resources 
of the profession. From all we can gather, it would seem that 
little, if any, progress was made in the principles or practice of 
medicine for many centuries. Herophilus is mentioned by some 
as a reformer in medicine, and as having introduced quite a 
large number of medicines ; but what they were, history fails 



PRACTICAL PRINCIPLES. 21 

to tell us. Dioscorides states that the medicines used by him 
had the power to dissolve stone in the bladder ; to consume the 
spleen ; to prevent conception in females ; of making children 
black-eyed, &c. ; also, that they would prevent the various mani- 
festations of mental emotions and passions. The modus 
operandi of medicines, as explained by the ancients, was that 
they acted upon the system- according to the degree of heat or 
cold, dryness or moisture, of the system. A principle not very 
dissimilar to that advocated by the modern Samuel Thomson, 
which was that heat was life, and cold was death ; and that 
medicines acted beneficially or otherwise, according to the degree 
of heat they contained. 

iEtius, who lived at the commencement of the sixth century, 
and was the first physician of eminence who embraced the 
Christian religion, dispensed with most of the ceremonies, magic 
and incantations, that originated in the iEsculapian school; but 
instituted others almost equally superstitious. In his directions 
to use certain medicines, he recommended that the following 
words be repeated in a low voice : May the God of Abraham, 
the God of Isaac, the God of Jacob, deign to bestow upon this 
medicine the necessary virtues, &c. In extracting a foreign 
substance from any part of the system, he recommends, in con- 
nection with proper means used, the following words : As Jesus 
Christ caused Lazarus to come forth from the sepulchre, as 
Jonah came out of the whale's belly, come thou out. In his 
practice he made free use of the cautery, and introduced a 
number of new ointments. He also claimed to have introduced 
to the materia medica several new remedies, but did not tell us 
what they were. His principles of practice were the same as 
his predecessors. 

Rhazes, an Arabian physician, although a strict imitator of 
the Greek practice, offered one or two suggestions worthy of 
remembrance. Among other considerations, he says: "studv 
carefully the antecedents of the man to whose care you propose 
to confide all you hold most dear in the world — that is to say, 
your life and health, and the life and health of your wife and 
children. If the man is dissipating his time in frivolous plea- 
sures ; if he cultivates with too much zeal the arts that are fo- 
reign to the profession, such as music and poetry ; still more if he 



22 PRACTICAL PRINCIPLES. 

is addicted to debauchery, refrain from committing into his 
hands a trust so precious." 

Hally-Abas, Avicenna, and Albucasis, were also Arabian physi- 
cians of some note, and lived in the eleventh and twelfth centuries. 
They added to the resources of the Greeks several articles of 
some value, such as cassia, senna, and manna. They also added 
several ointments and syrups to the pharmacy. In the princi- 
ples of treating diseases, however, they made but little, if any, 
advancement. 

On examining the progress in the principles and practice of 
medicine, from its commencement to the close of the seventeenth 
century, we find that the principal improvements were made by 
the descendants of iEsculapius, Hippocrates and Galen ; that the 
Arabians, Turks, and Jews, did little, if any thing, more than 
teach it as it had been taught by Hippocrates. Even after the 
discovery of the art of printing by Guttenberg and others, in 
1424. physicians appeared to be entirely satisfied in translating 
the writings of ancient authors, and in commenting upon what, 
it would appear, they thought a fixed science. 

In the year 1700, John Fernel, who wrote quite extensively 
upon the materia medica, re-examined the therapeutic axiom of 
Hippocrates, that, all diseases are cured by contraries. He 
stated that every disease must be cured by contraries : for, says 
he, " a remedy is that which can drive out a disease, and that 
which drives acts violently. That which uses violence is in 
opposition, therefore the remedy is always opposed to the dis- 
ease, and no healing can take place except in virtue of the law 
of contraries. We call contraries not only those things which 
are endowed with opposite elementary qualities, heat and cold, 
dry and wet, but also things which differ among themselves in 
any way, as to quantity, number, quality, &c. Thus the hard 
and the soft, the dense and the diffuse, the great and the small, 
that which is in excess and that which is deficient ; the high and 
the low, the pure and the impure, are all examples of contraries. 
These are the views of Fernel relative to the therapeutic action 
of medicine, although he carried them further than Hippocrates 
and Galen, and entirely rejected their experimental knowledge 
of therapeutics, and claims the law of contraries to be impos- 
sible. 



PRACTICAL PRINCIPLES. 23 

Paracelsus, a native of Einsiedeln, a village of Switzer- 
land, lived in the latter part of the sixteenth century, and 
although a man of neither integrity of purpose, nor stability of 
character, obtained almost universal sway over the medical pro- 
fession. He claimed to have made great discoveries in thera- 
peutics and pathology. He stated that the human body, like the 
great world of which it is an image, is composed of four elements, 
fire, air, earth and water. The fire in man is the soul ; the earth 
is represented by the dry parts ; the water by the liquids ; the air 
by the vacuum. These four elements cause disease. But if we 
leave this high analysis to get at the more immediate elements, 
the body of man is composed of mercury, the liquor of sulphur 
and salt. And now we see how this is demonstrated by alchymy. 
There are, in the first place, in the body liquids ; these are the 
mercury; then the solids, which may be burnt; the portion 
which burns is sulphur, while the residue or the ashes is salt. 
It can hardly be imagined how a man can embody, in so few 
words, such an amount of ignorance, and, what is still more 
wonderful, is, that a system, thus founded in the grossest igno- 
rance, should exert such an influence on the medical profession. 
The additional element of mercury, which he added to the four 
elements of the ancients, enabled him to found a new system of 
therapeutics, and in a measure to introduce new principles of 
cure. Mercury, he tells us, being in close relation to ordinary 
quicksilver, produces, by its volatility, many affections of 
the ligaments, as tremblings, &c. If it becomes excessive, or if it 
be joined to acrimony, mania, phrenzy and madness occur. On 
the contrary, if the mercury is chilled, it causes trembling of 
the hands and feet, lethargy, erosions of the mouth, &o. Sul- 
phur causes various kinds of fevers, jaundice, &c. Salt causes 
gravel, gout, sciatica, and, when it becomes dissolved, it causes 
diarrhoea; if it coagulates, constipation; if it volatizes too soon, 
it causes ulcers, itch, erysipelas, cancers, herpes, &c. .For the 
purpose of removing all these diseases, he introduced into the 
system antimony, gold, mercury, copper, and some other metals. 
He discarded many of the remedies of Hippocrates as being in- 
effectual and unable to control the elements of the body, and 
pretended the principle upon which mercury removed disease 
from the body was a profound secret, peculiar to himself. It 



24 PRACTICAL PRINCIPLES. 

was a combination of these metals which composed what he 
called his elixir vitce, or universal remedy for all diseases. One 
attempt which he made to explain the modus operandi of his 
medicines, will suffice to show his Entire ignorance upon the 
subject. It was as follows : — "As antimony purges gold only, 
and consumes all other metals, it is the proper agent to purge 
the human body, and no other ; for in regard to perfection and 
forces, man has a great similitude to gold ; whence it follows, 
that antimony brings man and gold to a supreme degree of per- 
fection and purity, while it destroys, consumes and exempts 
every thing else. The nature of antimony is a purgative, though 
it does not produce evacuation of faeces and other excrements ; 
but, above all other remedies, which act insensibly, it drives out 
that which renders man impure, and having purged the cause 
of disease, brings him to a supreme degree of health." It will 
readily be perceived from the above quotation, that in the adminis- 
tration of medicine, he was guided for less by correct principles 
than his predecessors in the profession. Paracelsus was the 
first physician who used mercury and the other violent mineral 
poisons. Andrew Libanius, a physician, chemist and director 
of the gymnasium at Cobourg, and cotemporary of Paracelsus, 
informs us that the latter cured very few of his patients ; that he 
killed a great many, and that many others were horribly tor- 
tured by the use of his medicaments. As ignorant and unskillful 
as was Paracelsus, he is the founder of the present system of 
Allopathy ; and the very remedies of which he composed his 
quack elixir, are still insisted upon as being the almost universal 
panacea for bodily ills. It is true that men, eminent in the pro- 
fession, have labored for a more rational system of practice ; have 
minutely investigated the cause and nature of disease, and have 
very materially improved the condition of pathology. But not- 
withstanding all this, it must be acknowledged that their thera- 
peutic resources are essentially the same as those of Hippocrates 
and Paracelsus. By referring to the compendium of Dr. Eberle's 
Practice, in another part of this work, we can learn what the 
resources of the Allopathic portion of the profession are. I* 
be sure, every article is not there enumerated which has been 
recommended by that branch of the profession • but, he being a 
late author, and having enjoyed the confidence of the profes- 



PRACTICAL PRINCIPLES. 25 

sion as such for nearly a quarter of a century, it is probable he 
as fairly represents his party in medicine as any author I could 
select. According to all their authors, bleeding, blistering, 
mercury, antimony, &c, are their principal therapeutic re- 
sources. With these are they successful in accomplishing the 
only purpose for which medicine is cultivated? — that of healing 
disease. The first of these resources, in order, is bleeding. Is 
bleeding of service in the treatment of disease ? Is it produc- 
tive of more good than evil ? These are questions which should 
be solved before venturing upon so active a measure in changing 
the normal condition of the human organism. 

To assist us in the solution of this question, we may first in- 
quire, what are the purposes of the blood ? what part does it 
perform in the economy of human life. Scripture tells us that 
the blood is the life of the flesh. Physiology tells us that the 
blood is the histogenic material, out of which all the organs of the 
body are formed, and by which they maintain their normal 
integrity. Pathology, still further, informs us that a large 
majority of all disease that afflicts the human family is depen- 
dent upon, or is caused by, a deficiency in the whole, or in certain 
constituents of the blood. Physiological pathology informs us 
that the blood is a medium through which all the disintegrated 
or waste portions of the old tissue are removed from the body ; 
that it watches diligently over every tissue, and carefully supplies 
every deficiency. Still the question is, does it remove disease t 
What are the facts? The following remarks o£ Dr. Samuel 
Dickson, formerly an officer of the British staff, now of London, 
will show some facts upon the utility of blood-letting in the 
treatment of disease. "A medical officer of one of her majesty's 
regiments, serving in India, couched a woman for cataract. 
The next day the eye having become inflamed, according to 
received practice, he bled the patient; but scarcely had he 
bound up her arm, when she fell as if she had been shot, and 
lay, to all appearance, dead ; with the greatest difficulty he 
succeeded in recovering her from this state : but it was not till 
four long hours had passed that he felt he could safely leave her 
with attendants ; for during the greater part of that time, when 
he ceased to chafe her temples, or otherwise call up the attention 
of the brain, by the application of stimulants to the nose, mouth, 
3 



26 PRACTICAL PRINCIPLES. 

&c, she relapsed into a death-like swoon. More than once he 
was obliged to inflate her lungs to keep her from dying. But 
in this ease, gentlemen, blood-letting did not cure the inflamma- 
tion ; for the next day the eye was more painful and inflamed 
than ever, and the poor woman, after all the blood she had lost, 
— and who will sa.y that she was not bled? — did not recover 
her sight. It is now many years since that case came under 
my sight, and it made an impression on my mind I shall never 
forget. Had the woman died, would not every one have said 
that the gentleman who bled her had killed her? and very 
justly, too." 

" Religion Freedom, Vengeance, what you will, 
A word's enough to raise mankind, to kill — 
Some party-phrase by cunning caught, and spread, 
That Guilt may reign, and Wolves, and worms be fed." 

" The first resource of the surgeon is the lancet — the first 
thing he thinks of when called to an accident, is, how he can 
most quickly open the flood-gates of the heart, to pour out the 
stream of an already enfeebled existence. Does a man fall from 
his horse, or a height, is he not instantly bled? has he been 
stunned by a blow, is not the lancet in requisition? Nay, has 
an individual fainted from over-exertion or exhaustion is it not 
a case of fits — and what so proper as venesection ? You can- 
not have forgotten the fate of Malibran — the inimitable Mali- 
bran ; she who so often, by her varied and admirable perform- 
ances, moved,, you to tears and smiles, by turns. She was playing 
her part upon the stage ; she entered into it with the whole of 
her soul, riveting the audience to the spot by the very intensity 
of her acting. Just as she had taxed the powers of her too 
delicate frame to the utmost, she fainted and fell ; fell from very 
weakness. Instantly a medical man leapt upon the stage, — to 
administer a cordial ? No, to bleed her! to bleed a weak, worn, 
and exhausted woman ! and the result? She never rallied from 
that unfortunate hour. But, gentlemen, Malibran was not the 
only intellectual person of the thousands and tens of thousands 
who have prematurely perished by the lancet. Byron and Scott, 
those master-spirits of their age — those great men, who, like 
Ariosto and Shakspeare, not only excited the admiration of 
cotemporary millions, but whose genius must continue, for gen- 



PRACTICAL PRINCIPLES. 27 

erations jet unborn, to delight the land that produced them — 
they, too, fell victims to the lancet — they, too, were destroyed 
by the hands, -which, however friendly and well-intentioned, 
most undoubtedly dealt them their death-blow. Is not this a 
subject for deep reflection ? To the cases of these great men we 
shall recur in the course of this lecture; but, for the present, 
we must turn to other matters — to events that have just passed 
before our eyes. The affair of Newport, in Wales, is still the 
topic of the hour. You must therefore remember it to its min- 
utest detail — the attack of the rioters upon the town; the 
gallant and successful stand made by Capt. Gray and his little 
detachment of the 35th regiment — the prisoners captured and 
the investigation which took place afterwards. In the course 
of that examination a prisoner, who was under examination, 
fainted. What was done with him ? he was carried out of 
court and immediately bled. On his return an extraordinary 
change had come over his countenance : from being a man of 
robust appearance, he had becnme so wan and haggard, so 
altered in every lineament, the spectators could scarcely recog- 
nize him as the same prisoner. Yet, strange to say, not one of 
the many journals that reported this case, spoke a word in con- 
demnation of the uncalled-for measure which brought the man 
to such a state ; so much has custom blunted the sense of the 
public to this, the most dangerous of all medical appliances. 
Gentlemen, a coroner's inquest was held on a person who died 

suddenly. Mr. , surgeon, stated that he was called upon to 

attend deceased, and found him at the point of death. He 
attempted to bleed him, but ineffectually, and in less than a 
minute from witness' arrival, deceased expired. "Witness not 
being able to give any opinion as to the cause of death from the 
symptoms that then exhibited themselves, he afterwards, with the 
assistance of Dr. Ridge, 37 Cavendish Square, made a post-mortem 
examination, and found that a large tumour, attached to a large 
vessel of the heart, containing blood, had bursted, and that was 
the cause of his death. So that, while the man was actuallv dvinn- 
of inanition from internal bleeding, the surgeon, utterly igno- 
rant, according to his own confession, of the nature of the 
disease, proceeded to open a vein. How happens it that the 
lancet should be so invariably the first resort of ignorance. 



28 PRACTICAL PRINCIPLES. 

" In every case of stun or faint, the employment of this instru- 
ment must be a superadded injury; in all, there is a positive 
enfeeblement of the whole frame, evidenced by the cold surface 
and weak but imperceptible pulse ; there is an exhaustion, which 
loss of blood, so far from relieving, too often converts into a state 
of utter prostration. True, men recover when treated in this 
manner — but these are not cures, they are escapes. How few the 
diseases which loss of blood may not of itself produce ! if it 
cannot cause the eruptions of small-pox, nor the glandular 
swellings of plague, it has given rise to disorders more immedi- 
ately fatal than either. What think you of cholera asphyxia — ■ 
Asiatic cholera? Gentlemen, the symptoms of that disease are 
the symptoms of a person bleeding slowly away from life. The 
vomiting, the cramps, the sighing, the long gasp for breath, the 
leaden and 'livid countenance which the painter gives to the 
dying in his battle-pieces ; these are equally the symptoms of 
cholera and loss of blood. Among the numerous diseases which 
it can produce, Darwin says, ' a paroxysm of gout is liable to 
recur on bleeding.' John Hunter mentions ' lock-jaw and 
dropsy' among its injurious effects — Travers, 'blindness and 
palsy ' — Marshall Hall, ' mania ' — Blundell, ' dysentery * — 
Broussais, 'fever and convulsions.' 'When an animal loses a 
considerable quantity of blood/ says John Hunter, ' the heart 
increases in its frequency of strokes, as also in its violence/ 
Yet these are the indications for which professors tell you to 
bleed. You must bleed in every inflammation, they tell you. 
Yet is not inflammation the daily effect of the loss of blood ? 
Magendie mentions pneumonia as having been produced by it, 
completely confirming the evidence of Dr. Hume upon that 
point. He further tells us, that he has witnessed among its 
effects the entire trains of what people are pleased to call in- 
flammatory phenomena ; and mark, he says, the extraordinary 
fact, that this inflammation will have been produced by the very 
agent that is daily used to combat it! What a long dream of 
false security have mankind been dreaming ! they have laid 
themselves down on the laps of their Mentors, — they have slept 
a long sleep ; while these, like the fabled vampire of the poets, 
taking advantage of a dark night of barbarism and ignorance, 
have thought it no-sin to rob them of their life's blood during 



PRACTICAL PRINCIPLES. 29 

the profoundness of their slumber! Gentlemen, the long shiver 
of the severest ague, the burning fever, the severest lock-jaws, 
the vomiting, cramps, and asphyxia of cholera, the spasm of 
asthma and epilepsy, the pains of rheumatism, the palpitating 
and tumultuous heart, the most settled melancholy and madness, 
dysentery, consumption, every species of palsy, the faint that 
becomes death, these — all these — have I traced to the loss of 
blood ! 

" Lord Byron called medicine the destructive art of healing. 
How truly it proved to be so in his own case, you shall see when 
I give you the details of his last illness: — 'Of all his preju- 
dices/ says Mr. Moore, ' he declared the strongest was that 
against bleeding. His mother had obtained from him a promise 
never to consent to be bled ; and, whatever arguments might be 
produced, his aversion, he said, was stronger than reason. Be- 
sides, is it not, he asked, asserted by Dr. Reid, that less slaughter 
is effected by the lance than by the lancet — that minute instru- 
ment of mighty mischief!' On Mr. Millingen observing that 
this remark related to the treatment of the nervous, but not of 
inflammatory complaints, he rejoined, in an angry tone, 'Who 
is nervous if I am not? and do not those other words of his (Dr. 
Reid's) apply to my case, where he says that drawing blood 
from a nervous patient, is like loosening the cords of a musical 
instrument — whose tones already fail for want of sufficient 
tension ! Even before this illness, you yourself knew how weak 
and irritable I had become ; and bleeding, by increasing this 
state, will inevitably kill me. Do with me what else you like, 
but bleed me you shall not. I have had several inflammatory 
fevers in my life, and at an age when robust and plethoric ; yet 
I got through them without bleeding. This time, also, will I take 
my chance/ After much reasoning and repeated entreaties, 
Mr, Millingen succeeded in obtaining from him a promise, that 
should he feel his fever increase at night, he would allow Dr. 
Bruno to bleed him. On revisiting the patient early next morn- 
ing, Mr. Millingen learned from him that, having passed on the 
whole, as he thought, a better night, he had not thought it 
necessary to ask Dr. Bruno to bleed him. What followed I shall, 
in justice to Mr. Millingen, give in his own words: 'I thought 
it my duty now to put aside all consideration of his feelings, 



30 PRACTICAL PRINCIPLES. 

and to declare, solemnly, to him how deeply I lamented to see 
him trifle thus with his life, and show so little resolution. His 
pertinacious refusal had already, I said, caused much precious 
time to be lost; "but few hours of hope now remained ; and, un- 
less he submitted immediately to be bled, we could not answer 
for the consequences. It was true he cared not for life, but who 
could assure him that, unless he changed his resolution, the un- 
controlled disease might operate such disorganization in his 
system as utterly and forever deprive him of reason ! I had 
now hit at last on the sensible chord ; and partly annoyed 
by our importunities, partly persuaded, he cast at us both the 
fiercest glance of vexation, and throwing out his arm said, in 
the angriest tone, ' There you are, I see, a d — d set of butchers, 
take away as much blood as you like, but have done with it P 
We seized the moment (adds Mr. Millingen), and drew about 
twenty ounces. On coagulation, it presented a strong buffy coat, 
yet the relief obtained did not correspond to the hopes we had 
formed, and during the night the fever became stronger than it 
had been hitherto, the restlessness and agitation increased, and 
the patient spoke several times in an incoherent manner. Surely 
this was sufficient to convince the most school-bound of the 
worse than inoperative nature of the measure. Far from it. On 
the following morning, the 17th of April, the bleeding was re- 
peated twice, and it was thought right also to apply blisters to 
the soles of his feet ! Well might Mr. Moore exclaim, ' It is 
painful to dwell on such details/ For our present purpose it is 
sufficient to state, that although the rheumatic symptoms had 
been completely removed, it was at the expense of the patient's 
life. His death took place upon the 19th, that is, three days 
after he was first bled. 

" M. Capeman, in 1845, gives the statistics of the bleeding and 
non-bleeding practice in apoplexy. * In 1836, when I first re 
pudiated the lancet in this disease, the statistics were all on one 
side, the only cases of the non-bleeding side of the argument 
being my own/ The following is from Mr. Capeman's table : 

Number bled 120 Cured 51 Died 78 

Number not bled 26 Cured 18 Died 8 

Showing that, in the cases where bleeding was practised, nearly 



PRACTICAL PRINCIPLES. 31 

two out of three died ; whereas, in the cases treated without 
blood-letting, more than two out of three recovered ! What is 
the worth of general assertions in the face of such evidence? 

" In the army hospitals I had an opportunity of studying dis- 
ease both at home and abroad. There I saw the fine tall soldier 
bled, for relief of a symptom, to fainting ; and what is fainting ? 
A loss of every organic perception — a death-like state, only 
differing from death in the possibility of a recall. Prolong it to 
permanency and it is death. Primary symptoms were, of course, 
got over by such measures ; but once having entered the hospital 
walls, I found that soldier become familiar to me ; seldom did 
his pale countenance recover its former healthy character. He 
became the victim of consumption, dropsy, or dysentery. His 
constitution was broken by the first depletory measures to 
which he had been subjected." 

In connection with these cases, reported by Dr. Dickson, we 
might mention that of our own Washington, who, after escaping 
the perils of war with its engines of death, fell a victim to the 
lancet. He was attacked with quinsy — bled to an enormous 
extent, three times within a few .days, and died with all the 
characteristic symptoms of fatal hemorrhage. 

Andral recently reported one hundred cases of pneumonia 
treated by blood-letting ; one hundred treated by antimony and 
mercury, and one hundred by diet and rest. Of the cases 
treated by blood-letting, 27 died ; of those treated by antimony 
and mercury, 21 died ; by diet and rest, 7 died. 

To the candid and impartial observer of facts, the general 
fatality accompanying this practice is conclusive on this point. 
Within my own experience I could enumerate hundreds who, 
while in the bloom of health, upon some trifling ailment have 
submitted themselves to be bled, and thus offered up their lives 
upon the altar of this murderous practice. These are a few 
among the many facts which lead us to condemn the use of the 
lancet. Another therapeutic agent in the allopathic materia 
medica which we reject, is mercury with all its preparations : 
for ample experience has shown, that the allopathic axiom, that 
medicines which will produce one train of morbid phenomena, 
will remove an already existing disease, is not successful in 
combating disease ; but, on the contrary, has greatly enlarged 



32 PRACTICAL PRINCIPLES. 

the bills of mortality, and increased the amount of human suf- 
fering. It is not true that two diseases will not manifest them- 
selves in the human organism at the same time, as common 
observation will show. It is true that while patients are laboring 
under the specific influence of mercury, they, at the same time, 
suffer from the ravages of other morbid influences equally 
disastrous to the life and health of the patient. Nothing is 
more common than to see patients die of idiopathic fevers, s 
83'philis, small-pox., phthisis, pneumonia, pleurisy, inflammation 
of the brain, stomach, bowels, &c, while under the specific 
influences of mercury. Statistics show that a much larger por- 
tion die, when thus treated, than when left to the unaided efforts 
of nature. This fact was fully appreciated by Lord Byron after 
recovering from a very severe attack of fever. He stated that 
after a week of half delirium, burning skin, hot headache, hor- 
rible sensations, and no sleep, by the blessing of barley-water, 
and refusing to see his physician, he recovered. 

Lord Byron was not the only one who realized the inefficiency 
of the allopathic method of treating disease. A large majority 
of the most intelligent people have felt, for the last two-thirds 
of a century, the importance of an entire revolution in our 
therapeutic resources. The following are the preparations of 
mercury most in use : 

The blue-pill, which is a preparation of quicksilver, rose-leaves 
and honey. 

Bichloride of mercury, or corrosive sublimate. 

Chloride of mercury, or Calomel. 

Ammonio-chloride of mercury, or White Precipitate. 

Red Oxide of mercury, or Red Precipitate. 

Bicyanide of mercury. 

Sub-sulphate of Peroxide of mercury. 

Nitrates of mercury. 

Iodide of mercury. 

The symptoms of large doses of Bichloride of mercury, as 
described by Taylor in his Medical Jurisprudence, page 87, are 
nausea, with vomiting of long stringy masses of white mucus, 
mixed with blood, followed by profuse purging. 

The pulse is small, frequent, and irregular, being scarcely 
perceptible as the disease advances. The tongue is white and 



PRACTICAL PRINCIPLES, 33 

shriveled, the skin is cold and clammy, the respiration difficult, 
and death is commonly preceded by fainting, convulsions, and 
insensibility. The mouth is swollen and the urine is suppressed. 
The symptoms produced by corrosive sublimate, in the first in- 
stance, resemble cholera. The quantity necessary to destroy life, 
according to Taylor, is from three to five grains. 

Chloride of mercury, or calomel, is poisonous in doses similar 
to corrosive sublimate. A case is reported in the Medical 
Gazette (18 vol., p. 484), in which a boy, aged fourteen, was 
killed by one dose of six grains of calomel. 

It is stated, by Mr. Taylor, that no salivation was produced in 
this case. Pereira mentions a ease of a lady who was killed by 
a dose of twenty grains of calomel. Sobernheim states that a 
girl, aged eleven, took eight grains of calomel in twenty-four 
hours, for croup, and died in eight days from inflammation and 
ulceration of the mouth and fauces. 

Dr. Taylor mentions a case, which occured at Lesser, where 
fifteen grains of calomel produced similar effects, and the patient 
died in eight days. Dr. Christian mentions a case in which two 
grains of calomel destroyed life by the severe salivation induced, 
as well as by the ulceration of the throat. Taylor, in his Medi- 
cal Jurisprudence, page 80, mentions a case, where two-thirds 
of a grain of calomel was given to a boy, aged eight years, pro- 
ducing violent salivation and necrosis of the bones. 

In another instance, a little girl, aged five, took daily, for three 
daysj three grains of mercury and chalk-powder. Her mouth 
was severely affected ; sloughing ensued, and she died in eight 
days. In a third case, a boy, aged eleven years, took throe 
doses of this powder — one of six grains on the 14th, a similar 
dose on the 17th, and four grains on the 20th, making altogether 
sixteen grains. The most profuse salivation ensued, sloughin^ 
commenced in both cheeks and rapidly extended through them. 
The boy died in four days. Previously to the exhibition of the 
mercury he had recovered from an attack of fever. In a fourth 
case, three grains of blue pill, given twice a day, for three days, 
making eighteen grains,, were ordered for a girl, aged nineteen, 
who complained of a slight pain in her abdomen. Severe sali- 
vation supervened, the teeth separated, and she died in twelve 
days. Dr. Craigie says the great objection to the employment 



34 PRACTICAL PRINCIPLES. 

of any preparation of quicksilver in the cure of renal disease, 
consists in the fact, that the use of the mineral is known to 
render the urine albuminous, to increase the inflammatory state 
of the system, and to induce the disease, the effects of which, it 
is expected, to remove. Another evil is that, in persons laboring 
under symptoms of granular kidney, a very small quantity of 
mercury induces salivation, and renders the mouth tender and 
most painful. (Practice of Physic, ii., 1148.) 

Prof. Z. Freeman reports a case, in the August number of the 
Eclectic Medical Journal, 1854, p. 345, of a girl who took calo- 
mel and jalap for a cathartic. It was followed by severe saliva- 
tion, gangrene and necrosis of the jaw bone. He states, that 
himself and Dr. Newton took from the jaw four pieces of bone, 
each over an inch in length and three-fourths of an inch in 
thickness, including a number of teeth. The jaw was anchy- 
losqd and the mercurial bone foetor was very offensive in this 
case. He mentions another case which came before him while 
he was lecturing in Memphis, in which the jaw was necrosed, 
and the features horribly mutilated, as the effects of mercury. 
I knew a case of a lady, treated by a homcepathic physician for 
remittent fever, who took corrosive sublimate, as admitted by 
the physician, one grain a day, for three days, producing violent 
salivation and ulceration of the mouth, w T ith a strong tendency 
to gangrene, followed by persistent vomiting, prostration, and 
death in the course of five or six w r eeks. Upon making a post- 
mortem examination, the mucous membrane of the stomach, and 
upper portion of the bowels, were found entirely disorganized by 
the effects of the mercury. 

Dr. Norris, surgeon in the Pennsylvania Hospital, stated, in 
a recent clinic, that he had not prescribed mercury in cases of 
syphilis for the last twenty years, and that patients did much 
better than before. Dr. Dick, of Calcutta, states, in a letter to 
Dr. Sanders, that chronic liver attacks frequently follow the 
long continued use of mercury. Dr. Nichols, surgeon in the 
British army in India, states that most of the soldiers, who were 
treated for venereal disease with mercury, were exceedingly liable 
to inflammation of the liver. Dr. M. Dessuelles, that from his 
experience in the treatment of one thousand three hundred and 
twelve cases of primitive and secondary syphilis without mer- 



PRACTICAL PRINCIPLES. 35 

cury, that the average duration of the disease was only thirty- 
two days, while those treated with mercury were not only 
subject to a much longer period of the disease, but a far less 
number recovered. Prof. J. G. Jones stated, in his lectures, that 
he had not used a grain of mercury for twenty years. And it 
is well known that he treated every variety of disease with 
almost uniform success. 

Dr. Pulte, in his Homoepathie Domestic Physician, states that 
mercury causes the following diseases and symptoms. Hence 
he recommends it to cure the same, upon the principle described 
by Shakspeare. 

"Tut, man ! one fire burns out, another's burning; 

One pain is lessened by another's anguish : 

Turn giddy and be helped by backward turning ; 

One desperate grief cures with another's languish ; 
Take thou some new infection to thine e}*e, 
And the rank poison of the old will die." 

Swelling and inflammation of the glands ; inflammatory fevers, 
with disposition to perspire profusely ; rheumatic, or catarrhal 
headache ; scrofulous rheumatic ophthalmia ; syphilitic ophthal- 
mia; rheumatic prosopalgia and tooth-ache; dysentery; mucous 
or bilious diarrhoea ; influenza. 

Symptoms: — Enlargement, inflammation, and ulceration of 
the glands, with pulsative and shooting pains. 

Copious and colliquative sweats. 

Vertigo, principally On getting up. 

Itching, tickling and burning in the eyes. 

Tearing, stinging and drawing pains in the ears. 

Bloatedness and swelling of the face. 

Tearing, stinging, or pulsative pains in the carious teeth. 

Putrid smell from the mouth. 

Stinging pains in the throat and tonsils, principally when 
swallowing. 

Acid and mucous taste ; dislike to all food. 

Violent empty eructations ; excessive tenderness of the stomach 
and precordial region. ■ 

Loose and dysenteric evacuations. 

Frequent, copious emissions of urine, like diabetes. 

Catarrh, with febrile shivering. 



36 PRACTICAL PRINCIPLES. 

Difficulty of respiration, with attacks of suffocation at night. 

Obstructions and inflammatory swellings of the glands of the 
neck. 

Sharp pains in the shoulders and arms. 

Sharp and piercing pains in the hip-joints. 

We have given some of the~reasons why we reject the use of 
mercury and all its preparations in the treatment of disease. 
We urge the same objections against the medicinal use of copper, 
antimony, arsenic, lead, zinc, tin, in short, against all minerals 
not found as a component part of the organic structure of the 
human body. And if our limits would permit, we could produce an 
array of facts, proving, beyond a reasonable doubt, that the use 
of all these mineral substances is absolutely disastrous to health 
and life. The mineral substances, which are constituents of the 
human organism, and can be used with benefit in the treatment 
of disease, are the following : * 

Lime, or its base, calcium, is combined with the carbonic or 
phosphoric acid, in the bones and teeth. 

Magnesia, in the sebaceous matter of the skin. 

Alumina, in the enamel of the teeth. 

And iron in the black pigment of the various parts, and in the 
blood. 

Metallic bases of earth : — Calcium, magnesium, silicium, 
aluminum. 

Phosphorus, sulphur, chlorine, and fluorine. 

Metals ; iron, manganese, titanium. 

Water, found universally, composed of hydrogen and oxygen. 

Carbonic acid, found in urine, blood, and sweat. 

Carbonates, or salts of carbonic acid and a base. 

Carbonate of soda, in serum, bile, mucus, sweat, saliva, tears. 
cartilage, &c. 

Carbonate of lime, in cartilage, bone and teeth. 

Carbonate of magnesia, in the sebaceous matter of the skin. 

Phosphate of soda, in serum, saliva, in sweat, bones, mus- 
cles, &c. 

Phosphate of lime, in bones, teeth, cartilage, and the sandy 
concretions of the pineal gland. 

* Wilson's Histology. 



PRACTICAL PRINCIPLES. 37 

Phosphate of soda and ammonia, in urine and blood ; but 
probably only for the purpose of being excreted or thrown off 
as unfit to constitute a part of the animal body. 

Phosphate of iron, in blood, gastric juice, and urine. 

Chlorine and its compounds : — 

Hydrochloric acid, in gastric juice and in the fluid of the 
caecum. 

Chloride of sodium, in blood, brain, bone, muscle, cartilage, 
pigment, and gastric juice. 

Chloride of potassium, in blood, gastric juice, milk and saliva. 

Chloride of ammonium, in sweat and gastric juice. 

Chloride of calcium, in gastric juice. 

Sulphuric acid and its compounds : — 

Sulphate of potassa, in urine, gastric juice, and cartilage. 

Sulphate of soda, in sweat, bile, and cartilage. 

Sulphate of lime, in bile, hair, and cuticle. 

Sulpho-cyanide of potassium, in the saliva. 

Fluoride of calcium, in the enamel of the teeth. 

Silica and oxide of manganese, in the hair. 

Alumina, in the enamel of the teeth. 

Oxide of iron, in blood, black pigment, lens and hair. , 

Oxide of titanium, in the capsulse renales. 

The above minerals, and their compounds, being constituents 
of the animal organism, necessarily play an important part in 
the great drama of organic life ; and disease of any of the 
tissues may, and frequently does occur, from a deficiency of 
some of the elements of the parts. The blood may become dis- 
eased from a deficiency of iron, sodium, or potassium ; in this 
case a proper administration of these articles may be beneficial. 
A lack of sulphur and soda in the system may cause a defi- 
ciency of bile; in which case a supply of them may restore the 
liver to its normal condition, and the bile to its natural quantity. 
Thus while all minerals, which constitute a part of the organic - 
structure, not only become assimilated and assist in restoring 
the abnormal conditions of the system to a healthy state — all 
minerals which do not enter into the organization of any of the 
various tissues, when introduced into the system, act as foreign 
agents, and prove a constant source of irritation, disease and 
death. Having hinted at what we conceive to be some of the 
4 



38 PRACTICAL PRINCIPLES. 

facts relative to the past and present condition of Medicine, we 
now proceed more directly to consider some of the principles 
which guide the great American movement for the reform of the 
medical profession. 

1st. A determined effort to ascertain more precisely than has 
been done hitherto the natural cause and events of diseases. 
Or, in other words, the fatality of disease when left to the 
unaided efforts of nature. 

2nd. A determination to understand more fully the modus 
operandi of medicines, and to ascertain their real curative 
powers. 

3rd. To continue our researches in the vegetable, mineral and 
animal kingdoms for the purpose of developing resources for the 
removal of disease. 

4th. To introduce into the profession a spirit of liberality and 
progression ; to dispense with all creeds and cliques, and to 
overcome all party prejudice among the different members of the 
profession. 

5th. That it is the duty of every physician to investigate each 
system of medicine, and make its valuable resources available 
for the relief of the sick. 

6th. That both science and experience have demonstrated that 
the use of mercury, lead, zinc, arsenic, and the entire catalogue 
of minerals, incompatible with the organic tissues, is a fruitful 
source of disease, and dangerous to life. 

7th. That blood-letting is one of those dangerous practices, 
which experience has found to be positively injurious in all 
cases. 

8th. That the pharmaceutical method of compounding a great 
variety of medicines into syrups, powders, pills, &c, not only 
prevents the physician from ascertaining their real curative 
powers, but the action of each is frequently neutralized, and the 
object defeated for which it was given. 

9th. That it is far better to leave the disease to the unaided 
efforts of nature, than attempt to remove it with medicine, un- 
less its indications are demonstrated by observation and science. 

10th. That investigation and research into the nature and 
cause of disease should be encouraged, and all new facts rela- 
tive to medical science should receive due attention. 



PRACTICAL PRINCIPLES. 39 

11th. That neither Allopathy, Homoeopathy, nor Hydropathy, 
as an exclusive system of medicine, has arrived at any consider- 
able degree of perfection, as shown by the fact that neither very 
materially lessens the natural fatality of disease ; although, 
occasionally, each of these may prove successful, as shown by 
the power of cold water to allay inflammation, which is Hydro- 
pathy ; by nitrate of silver for aphthae of the mouth, which 
is Allopathy; or by rhubarb for diarrhoea, which is Homoeopathy. 
Each of these systems of medication being occasionally appli- 
cable in removing disease, they should be understood by the 
physician, and adopted as indicated. 

12th. To discourage, by every honorable means, the baneful 
practice of constant drugging for all trifling diseases. 

13th. To investigate and adopt the physiological and hygienic 
methods of curing and preventing disease by a proper regulation 
of the diet, temperature and purity of the air, by bathing, 
friction, proper clothing, occupation, mental and physical train- 
ing, &c. 

14th. That the practice of physicians, of spending their time 
in idle conversation, electioneering. and otherwise, in pursuits 
foreign to the profession, disqualifies them for practice; and that, 
to be a skilful physician, the whole energies of body and mind 
should be devoted to the profession. 

15th. To avoid adopting any set of dogmas in medicine as 
infallible ; bearing in mind, that a constant change of opinion 
relative to the fundamental practical principles of the art, shows 
that what men supposed to be true at one time, have been proved 
to be entirely erroneous at another, and that the only means of 
advancing medicine to the rank of an exact science, is by the 
constant rejection of old errors and the reception of new and well- 
attested truths. 

16th. To combine the two extremes of the profession — the 
ultra-conservative and the fanatical reformer. As conservatives, 
we would pay due respect to the labors and discoveries of our pre- 
decessors in the profession, and adhere with commendable zeal 
and dignity to those doctrines which long usage, and extensive ex- 
perience and science have demonstrated to be true. As reformers, 
we would extend cur researches in every direction which promises 
accession to the already existing stock of medical knowledge, 



40 PRACTICAL PRINCIPLES. 

paying no homage to the aristocracy and learned pedantry of 
the profession, only so far as it has contributed to the advance- 
ment of science. Finally, that we adopt and adhere to the facts 
of the conservative, and enter into the labors of the reformer, 
with equal cordiality. 

17th. To use every practical means to inform the public upon 
the subject of medicine in all its departments, that they may 
understand the true merits of the different systems of medicine, 
and be prevented from trusting their lives and health in the 
hands of men ignorant of the principles and practice of the 
profession. 

18th. To cultivate the spirit of true Eclecticism, liberality and 
progression ; and to show the positive necessity that every phy- 
sician or student of medicine, who would acquit himself with 
honor and with fidelity to his practice, should not only pass 
through the ordinary and preliminary course of study, but that 
his whole time and attention should be devoted to the investiga- 
tion of all the therapeutic resources of every school of the pro- 
fession, selecting from each that which science and experience 
has proved beneficial in the treatment of disease. 

It will be seen from the foregoing, that the principles laid 
down as the basis of the American Medical Reform, cover every 
department of the science. That they propose to annihilate the 
boundaries of party limits ; to break the shackles which bind 
the conservative to his dogma ; to reinvestigate existing symptoms 
of medicine, and study anew all the laws of life and health ; to 
ascertain to what extent health may be promoted and disease 
prevented. This is the work which has been commenced by 
American Medical Reformers, and to the completion of which, 
they will consecrate their future labors. They desire to esta- 
blish a practice based upon scientific principles and inductive 
experience. They claim that, as a man is composed of the com- 
mon elements of matter, that to understand his organism in its 
physiological, pathological and therapeutical relations, is to 
understand his material structure and forms, with their various 
movements and forces, and cause of forces, which necessarily 
includes an intimate knowledge of the great branches of Physi- 
cal Science, vegetable, animal, and mineral, with all the laws 
and forces which control them, as electrical, magnetical, chemi- 



PRACTICAL PRINCIPLES. 41 

cal, dynamical, and physiological or organical. The fallacies 
of all former doctrines in medicine have, in a great measure, 
arisen from a want of this important knowledge. The 
allopathist, in establishing his system of medication, that all 
diseases are cured by medicines that alter or change the struc- 
ture or physiological forces of diseased parts, entirely omitted 
the chemical, organic and vital dependencies of matter, as the 
very disease which he intends to remove, by altering the organic 
tissue, may depend upon deficiency of carbon, nitrogen, hydro- 
gen or oxygen. As these substances alone possess the power of 
combining and forming the basis of all the elementary tissues, 
a deficiency of either of these elements may give rise to a series 
of pathological changes that no allopathic alterative could over- 
come, the only remedy being to introduce into the diseased organ- 
ism its original elements. 

Suppose the gastric fluid to be imperfect, as it frequently is, 
owing to a deficiency of oxygen to unite with the chyle and 
blood, out of which it is formed. Any attempt to re-establish the 
normal quantity by alteratives would prove as effectual as an 
attempt to reorganize water, after. the oxygen is set free, by 
adding alteratives. A deficiency of the carbonates may cause a 
disease of the liver, lungs, cartilage, bones or muscles. It is a 
fact that carbon, united with soda, constitutes a large portion of 
bile ; that, combined with lime, it forms one of the elements of 
the teeth, bone, &c; that it unites with oxygen in the lungs to 
maintain animal temperature. Let us inquire, of the allopathist, 
how many doses of mercury, how much alterative influence, 
from bleeding and blistering, will compensate for this deficiency. 
It must be borne in mind that the human system is an extensive 
organic chemical laboratory, in which is manufactured germ- 
cells, epithelium, mucus, muscle, nerves, brain, gastric juice, 
saliva, chyme, chyle, blood, lymph, tears, hair, nails, cuticle, 
cartilage, bone, &c. The object of this extensive manufactory 
is to furnish material for the constant demand made by the 
human body, that it may maintain its integrity and perpetuity. 
This constant demand arises from the fact, that not only all the 
inorganic, but the organic elements, which come in contact with 
the human organism, tend to unite with it and form new com- 
pounds, structures and forces, thereby disturbing the natural 
4* 



42 PRACTICAL PRINCIPLES. 

relations and dependencies of the human organism upon its 
organic elements, causing disintegration and destruction of the 
old tissue, which is supplied by these newly-manufactured pro- 
ducts. Any excess or deficiency in the supply is disease. And 
the only philosophical method of curing or removing such 
abnormal conditions is to supply elementary deficiencies, pre- 
vent excesses, and maintain the natural relation of elementary 
principles to the human organism. What is true of Allopathy 
is equally true of Homoeopathy. Who, after a moment's reflec- 
tion, would suppose that chlorosis, which every pathologist 
admits is dependent upon a deficiency of iron in the blood, 
could be removed by infinitessimal doses of charcoal, oyster- 
shell, mercury and arsenic. Or who would suppose that the 
same remedies would remove disease of the bones, caused by a 
deficiency of lime and carbon in the system. But, what is still 
more ridiculous and absurd, in this hair-brain theory of Hahne- 
mann and his followers, is, that their remedies, as mercury, 
arsenic, belladonna, &c, are capable of causing, and consequently 
of curing, fifty or sixty diseases each. Jahr, in his Manual of 
Homoeopathy, vol. i., p. 563, states that sulphur will both cause 
and cure the feeling of despair of eternal salvation. Lachesis 
(p. 310, Jahr's Manual) produces, and hence should cure 
absence of religious feeling and fear of approaching death ; a 
small dose of gold, taken internally, produces excessive scruples 
of conscience, and despair of one's self and others ; veratrum 
produces extraordinary taciturnity, with oaths on the slightest 
provocation, and raving about religious matters. Aconite (p. 3) 
produces an irresistible desire to blaspheme and swear, and a 
sensation as if the mind was separated from the body. Ana- 
cardium (p. 33) produces the same swearing symptoms and 
absence of all moral and religious feelings; (vol. ii., p. 155) a 
dose of common colocynth (an ingredient in allopathic pills 
which most people have repeatedly swallowed) produces (says 
Jahr, p. 189) want of all religious feeling, &c, &c, &c. 
Lycopodium (club-moss) possesses the same power (p. 319) as 
sulphur, i. e. the feeling of despair of eternal salvation. Pulsa- 
tilla causes, and will cure, despair of eternal happiness, with 
continued prayer and devout aspects (Jahr, p. 468). 

Thus, while Homoeopathy is equally unphilosophical in its 



PRACTICAL PRINCIPLES. 43 

general principles, it has advanced some of the most extravagant 
notions relative to the action of medicine ever advocated by any 
sect in the profession since the magic incantations of the fol- 
lowers of iEsculapius. If it were true that these remedies 
would produce such terrible conditions of body and mind, the 
effects would be still more disastrous. 

In this case, a patient, who was curing, himself for itch with 
sulphur, would be seized with despair of eternal salvation ; also, 
according to Pulte's Homoeopathic Domestic Practice, p. 516, he 
would contract periodical and intermittent head-ache ; obstruc- 
tion of the ears, with humming and redness ; inflammation and 
ulceration of the nose; profuse perspiration day and night; con- 
gestion of blood in the head ; heat in the face ; tooth-ache ; sore 
mouth ; dislike for sweets ; pain in the abdomen ; constipation 
and piles. We can readily conceive how a person, who was 
suffering under the influence of the above disease, would be will- 
ing to endure many inconveniences to obtain relief, but, that he 
would exchange it for such a catalogue of ills is quite doubtful; 
and yet, if the homoeopathic doctrine be true, and their notions 
of the action of remedies correct, such would be the case ; and 
while one morbid condition of the human organism was being 
corrected, several hundred others would make their appearance. 
It is frequently claimed, by the disciples of this system, that 
although the law of similia similibus curaniiir cannot be esta- 
blished by appeal to the philosophy of medicine, still experience 
teaches it to be true in practice, and they have observed cases to 
recover while under its influence. This may be true, and yet it 
may not follow that the medication contributed in the least to 
the result ; as it is now a well-attested fact that, without medical 
interference, the average mortality of all disease in this country 
does not exceed seven per cent. Hence, to ascertain the useful- 
ness of any system of medicine, it is necessary not only to 
observe that some recover, but also how many the profession 
loses: if above seven per cent., it may be inferred that medica- 
tion increases the mortality of disease. The limits of this work 
will not permit me to enter into a full investigation of these 
different systems of medicine, and show what I conceive to be 
true relative to all their principles. But in accordance with the 
principles of American Eclecticism, while we would reject every 



44 PRACTICAL PRINCIPLES. 

hypothesis not founded upon science, we would gladly adopt 
whatever Homoeopathy, Hydropathy or Allopathy contributes to 
the real advancement of medicine. 

The therapeutic principles which guide us, then, are neither 
exclusively Homoeopathic, Allopathic, Hydropathic, Antipathic, 
Physiological, nor Hygienic ; but, by an intimate knowledge of 
the laws of life and organic elements of the different tissues, 
with a correct view of all the causes and influences brought to 
bear upon the human organism, together with a knowledge of 
all the physiological and pathological changes connected with 
disease, we are enabled to adopt such principles of cure as the 
nature of the case may indicate. In the choice of our remedial 
agents, we claim equal independence and liberality, selecting 
from all systems such as science and enlightened experience 
prove to be beneficial to the afflicted, having formed no definite 
"boundary to our researches ; for, as yet, no theory of medicine, 
as an independent system, has been able to stand the test of 
scientific analysis and experience. The following remarks of 
Thomas Jefferson, in a letter to Dr. Worcester, are to this point. 
He says: — " I have lived, myself, to see the disciples of Boer- 
haave, Cullen, Stahl, and Brown, succeed each other like the 
shifting figures of the magic lantern," and the practice predicated 
thereon, of course as evanescent and as changing as its sister 
theory ; and we, of the present time, have, most of us, witnessed 
one entire revolution in theory and practice of disease ; while 
we are at this very moment, on the last quarter of the full moon 
glory of a fast fading system. Where is the practitioner so 
wedded to the past, so tenacious of early practice, and so un- 
compromising of change as to risk his reputation or the lives 
of his patients, on the practice of twenty years ago ? It is more 
than probable that before another half century has passed, the 
present system of Hydropathy, Homoeopathy and Allopathy, 
like -the systems of Hoffman, Boerhaave, Cullen, Stahl, and 
Brown, will be remembered only as a relic of the past. The 
well-attested truths of each will, no doubt, be treasured up by 
the American democratic or Eclectic cultivator of medical 
science, to contribute to that perfection in medicine, which will 
enable it to take rank with Chemistry, Geology, or Mathematics. 
To accomplish this is the object of American Eclecticism. 



ANTIDOTES TO POISONS. 45 

For further consideration of this subject, the reader is referred 
to my large work on the American Practice of Physic, now in 
course of preparation. 



ANTIDOTES TO POISONS. 

The term antidote had, formerly, a much wider signification, 
and was applied to the remedies for diseases occurring from 
natural causes, as well as to the remedies for the derangement 
of the functions, arising from the direct introduction into the 
system of a known and material poison. 

The selection of appropriate means to counteract the effects of 
poisons must be determined by a knowledge of the manner in 
which each particular poison acts ; but as our limits will not 
permit us to enumerate or specify these, some general rules, 
only, will be given. 

The first indication is to remove the poisonous substance ; the 
second, is to prevent or limit its local effects ; the third, to 
obviate the effects on remote organs,- supporting their action by 
appropriate measures, till the injurious impression has subsided. 
The first of these is to be accomplished mostly by mechanical 
means. If the poison has been applied to any external part, as 
by the bite of a viper or rattle-snake, a cupping-glass, or what 
will answer as well, a wine-glass, tumbler or cup of any kind, 
from which a part of the air has been expelled, by holding within 
it a lighted candle for a second of time, should be applied 
immediately. 

If poison has been taken into the stomach, and is not of a 
kind to arrest instantly the action of the heart, its removal is to 
be attempted by the stomach-pump, or by exciting vomiting. 
The stomach-pump cannot well be used without introducing into 
the stomach a considerable quantity of water, which, by diluting 
the poison, lessens its violence, in all cases, except that of oxalic 
acid. But should a stomach-pump not be at hand, we must 
attempt to produce vomiting by every means in our power. For 
this purpose, a tablespoonful of flour of mustard, which is 
mostly to be found in every house, may be put into a tumbler of 
warm water, and given to the patient ; or twenty grains of Sul- 



46 ANTIDOTES TO POISONS. 

phate of Zinc (white vitriol), dissolved in a pint of -warm water, 
and the disposition to vomit encouraged by tickling the throat 
with a feather, and pressing on the pit of the stomach. Neither 
Ipecac, nor Tartar Emetic should be given, as their action is 
always preceded by much nausea, during which the absorption 
of the poison is often facilitated. 

When the poison is of a corrosive or irritant nature, instead 
of losing time in seeking the means of causing vomiting, it is in 
general advisable to adopt the second rule, and attempt to pre- 
vent or limit its local, and thereby its remote, effects. To accom- 
plish this we must ascertain what the poisonous substance was 
from which the patient is suffering, and must also know how it 
acts, as upon this depends the success of our treatment. The 
objects we should have in view are either to dilute, and so weaken 
it ; to supply from an external source the particular principle 
which the poison would abstract from the coats of the stomach ; 
or, by adding something to it, so change its nature as to render 
it comparatively or altogether harmless, which last will always 
be effected if we can succeed in forming an insoluble compound. 
The first may be done by giving plenty of warm water; and 
when we know the particular poison, if the warm water can be 
made the vehicle of an antidote, the second or third object will 
also be ensured. Suppose Sulphuric Acid (oil of vitriol) has 
been swallowed ; add to the water, chalk, magnesia, soda, sale- 
ratus or soap ; the acid will form with these substances purgative 
salts, and will, by their action on the bowels, assist in lessening 
the inflammation caused by the poison before its being neutralized. 
So when Sugar of Lead (acetate of lead) is swallowed, by giving 
Epsom Salts (sulphate of magnesia) we form an insoluble sul- 
phate of lead, which will be discharged by the bowels, operated 
upon by the magnesia, which has been freed from the sulphuric 
acid. Corrosive Sublimate (bichloride of mercury) abstracts 
from the coats of the stomach the albumen which they contain, 
by which it is converted into proto-chloride, or calomel ; now 
if, by giving white of egg, which is pure albumen, we supply it 
with the principle which it would otherwise obtain from the 
coats of the stomach, we shall preserve these entire. 

Such means, then, are antidotes properly speaking ; for the 



ANTIDOTES TO POISONS. 47 

means by which the secondary or remote effects are to be com- 
bated, deserved rather to be termed counter-poisons. The 
counter-poisons are of no small value in cases of poisoning by 
the corrosive or irritant, while they are of the utmost importance 
in the treatment of the sedative and narcotic poisons. To 
administer these appropriately, we must know which of the vital 
organs the poison most speedily affects. "When it affects the 
heart, the s}^mptoms greatly resemble S3 T ncope (or fainting), and 
as such poisons are the most dangerous, agents, which act as 
rapidly as the poisons, are alone to be trusted to : such agents 
are to be found among the diffusible stimuli, ammonia, or its 
carbonate, i. e. smelling-salts, applied to the nostrils, or dissolved 
in water and taken into the stomach, warm brandy and water, 
&c. Where it chiefly affects the spinal marrow, there occur 
spasms and difficulty of breathing; when the brain, there is a 
partial or complete insensibility (coma), often with, at first, full 
pulse, flushed face, and laborious breathing, resembling apoplexy. 
In such a state of affairs, artificial respiration, with the admin- 
istration of coffee and vinegar, greatly contribute to save the 
patient. 

Antidotes to Vegetable Alkaloids, 

In poisoning by opium, salts of morphia, hemlock, aconite, 
belladonna, strychnine, colchicum, &c, take iodine, gr. iij ; 
iodide of potassium, gr. vj ; water, 16 ounces. The stomach 
having been emptied, the mixture is to be given by glassfulls, 
still encouraging the vomiting; and to be followed (in the case 
of narcotics) by strong infusion of coffee. Purified animal 
charcoal absorbs and renders inert the active principles of many 
vegetable poisons, given in doses of an ounce or more, diffused 
in warm water. 

Antidotes to Metallic Poisons. 

The salts of mercury, copper and lead, are decomposed by 
the hydrated proto-sulphuret and per-sulphuret of iron, and the 
compounds produced are comparatively inert. The antidote for 
poisoning by arsenic is the hydrated sesquioxide of iron. It 



48 ANTIDOTES TO POISONS. 

may be made by adding carbonate of soda to the muriate of 
iron. It should be given in the moist state, mixed with water — 
after being once dried, it loses much of its power. 

When given in time, magnesia and chalk is an antidote for the 
mineral acids and oxalic acid ; albumen (white of egg) for cor- 
rosive sublimate and verdigris ; bark, for tartar emetic ; common 
salt for lunar caustic ; sulphate of soda or magnesia for sugar 
of lead and muriate of baryta; vinegar and oil for the fixed 
alkalis. These substances act either by neutralizing the 
corrosive power of the poison, or by forming with it an insoluble 
compound. 

From what has been said upon this subject, the necessity of 
an acquaintance with it must be sufficiently clear, not only to 
ensure our doing right, but to prevent us from doing wrong. By 
administering an ill-timed antidote, we may often hasten the 
fatal event ; as where vinegar is given when opium has been 
swallowed, before it has been ejected from the stomach ; and by 
throwing tobacco smoke into the bowels of a person apparently 
drowned, we extinguish the feeble spark of life, which might 
have sufficed to reanimate him, but for such injudicious inter- 
ference. 



AN EPITOME 



OF THE 



AMERICAN ECLECTIC PRACTICE OF MEDICINE. 



EPHEMERA. 

Ephemera is a fever which lasts but one day. Its 
symptoms are chilliness and anorexia or indifference to 
food, followed by a hot skin, flushed face, with hard and 
frequent pulse. In the course of from sixteen to twenty- 
four hours, these symptoms yield to a gentle perspiration, 
which lasts one or two hours, leaving no trace of fever 
save slight debility. It is mostly confined to children, 
and may be considered the simplest form of fever, requiring 
only mild treatment. 

TREATMENT. 

Give a warm bath by immersing the patient in warm 
water, or by sponging the surface frequently in warm sal- 
eratus water. If the head is hot, apply a towel wrung out 
of cold water, and change often. 

If the fever is persistent, add ten drops of the Tinct. of 
Aconite to ten tablespoonfuls of pure water, and give one 
teaspoonful every half hour until the fever subsides. If 
the bowels are confined, give a warm water injection. 
Warm or cold packs may be resorted to in case of local 
congestion. 

5 (49) 



50 INTERMITTENT FEVER. 

INTERMITTENT FEVER, OR AGUE. 

SYMPTOMS. 

Febrile paroxysms occurring at regular intervals of 
longer or shorter duration. But mostly recurring every 
twenty - four, forty - eight, or seventy - two hours. The 
twenty-four hour type is the Quotidian, the forty-eight 
hour the Tertian, and the seventy-two hour the Quartan. 
The interval between the paroxysms is called the Apyrexia. 
The period from the commencement of one paroxysm to 
the end of the next is called the revolution. Either type 
of this fever may appear in a double form. Thus, Quo- 
tidian frequently occurs twice a day, producing double 
Quotidian. The Tertian and Quartan, when occurring in 
a double form, produce a double paroxysm every second 
and third day. The double daily paroxysms have some- 
times been ascribed to the double Tertian. And their 
occurrence at different hours on alternate days, together 
with the difference in the severity of the paroxysms, have 
been described by Prof. Jones as diagnostic symptoms of 
double Tertian. But having frequently observed the Ter- 
tian type manifesting itself in double paroxysms every 
other day, with a perfect immunity from the disease on the 
Apyrexial day, I am led to infer that the double daily 
paroxysm, ascribed to the double Tertian, is only one 
modification of double Quotidian. This fever is generally 
preceded by languor, pain in the bones, irregular bowels, 
and alternate changes in the urine, which characterize the 
type of the approaching disease by occurring at the same 
regular intervals, and lasting the same length of time. 
These changes in the urine are from a light limpid to a 
dark yellow appearance. The tongue becomes covered 
with a white thin coat, and from one to two hours before 
the chill, the spleen yields a peculiar elastic resonance, 



INTERMITTENT FEVER. 51 

and becomes considerably increased in size. About this 
time distinct rigors or chills are felt, passing up the back 
and down the legs ; the teeth chatter, the nails become 
purple, the skin has the appearance of goose-flesh (cutis 
anserina) with Horripilations. If the chill lasts for any 
considerable length of time, there will -be oppressed breath- 
ing, with precordial pressure. 

In the course of from fifteen to thirty minutes these 
symptoms gradually subside, and at first a mild fever suc- 
ceeds, which continues to increase until the skin becomes 
dry and hot. The pulse increases in fulness and frequency, 
beating from 100 to 120 per minute. There is violent 
throbbing of the carotid artery, severe pain in the head, 
with dryness of the secretions, producing thirst, and scanty 
and high-colored urine. There is also much restlessness 
and uneasiness throughout the entire Pyrexia. 

These symptoms, modified in different individuals and 
localities, last from one to six hours, when they become 
mild, and terminate in the sweating stage. The skin now 
becomes covered with a profuse perspiration, the pulse 
becomes soft and natural, the respiration easy, and the 
patient feels as if almost restored to a state of health. 

TREATMENT. 

On the approach of the cold stage, the feet should be 
placed in warm water, and the patient caused to drink 
freely of some warm tea. After which he should be 
placed in bed, with covering of hot flannel, and jugs of 
hot water to the feet. As soon as the fever appears, the 
extra covering should be removed, and from one to ten 
drops of the Tinct. of Veratrum Yiride should be given 
every half hour until the fever subsides. Cold packs 
should be applied to the head, and hot sinapisms to the 
feet. The body should be frequently sponged in warm 
broke water, to which may be added a little whiskey. 



52 INTERMITTENT FEVER. 

During the Apyrexia, the following compound may be 
given for the purpose of interrupting and preventing the 
return of the paroxysm : 

R Eupatorin gr. xx. 

Cornine gr. xx. 

Citrate of Iron gr. x. 

Mix, divide into six powders, and give one every three 
hours, or oftener if it is necessary, in order to have them 
all taken before the return of the paroxysms. 

If the paroxysms return, the same treatment may be 
pursued as at first, during the cold and hot stages. 
After which, give the following compound : 

U Viburine.... gr. x. 

Rhusine .. gr. x. 

Salicin gr. xxx. 

Mix, divide into six powders, and give one every three 
hours, or oftener as the case may require. 

Or, 

R Bebeerine gr. xx. 

Quinine gr. x. 

Phosphate of Iron gr. x. 

Mix, divide into six powders, and give as above. 
Or, 

R Quinine.... gr. xx. 

Bitartrate of Potassa gr. xxx. 

Mix, divide into six powders, and give one every three 
hours. 

Or, 

U Chinoidin gr. xx. 

Capsicum gr. xx. 

Santonine gr. xx. 

Make ten pills, and give one every two hours. 



REMITTENT FEVER. 53 

Or, 

R Syrup of Bone Set , Oss. 

Chloride of Sodium (Common Salt) §j. 

Mix, dose 1 oz. every hour during the revolution. 

Z] of pulverized Sassafras Bark, taken at intervals of 
one or two hours during the revolution where the stomach 
will tolerate it, is generally sufficient to interrupt the pa- 
roxysms. Also a strong infusion of Strawberry root, 
taken freely during the interval, will generally effect a 
complete intermission. 

After the paroxysms have been entirely interrupted, a 
radical cure should be attempted by giving the patient a 
mild alterative, such as Euonymine, one or two grains, 
three or four times a day. If the bowels are costive, and 
do not yield readily to the Euonymine, add ^ or ^ of a 
grain of Podophyllin, and give sufficiently often to main- 
tain them in a soluble state. 

If the spleen continues permanently enlarged, Diuretics 
of Marshmallow and Cream of Tartar should be drunk 
freely. 

On the seventh, fourteenth, twenty-first, and twenty- 
eighth days succeeding the last paroxysm, one of the anti- 
periodic compounds should be given as at first. 

If the patient resides in an ague district, daily baths of 
warm lye water, together with a free use of Cream of 
Tartar and Marshmallow, will have a tendency to prevent 
a recurrence of the disease. 



REMITTEXT FEVEE. 

Eemittent Fever, like Intermittent, is generally pre- 
ceded by lassitude and yawning, with soreness and stiffness 
of the muscles, especially those of the neck and calves of 
the legs. The tongue is covered with a light yellow coat. 
5 * 



54 REMITTENT FEVER. 

The countenance is shrunken, pale, and of a leaden hue. 
The conjunctiva presents a congested appearance. The 
urine is thick and of a dark yellow color. The bowel? 
are costive. The liver is congested, and yields flatness on 
percussion. 

There is sense of weight in the Hypochondric and Epi- 
gastric regions. Creeping sensations of cold are suc- 
ceeded by flushes of heat, the taste in the mouth is me- 
tallic, the skin is sallow, and sleep is disturbed by alarming 
dreams. These symptoms increase in intensity, until the 
attack of the disease is established. As the hot stage be- 
comes developed, much of the pain about the legs and 
back frequently abates, although it often returns at the 
next exacerbation. Frequently, there is a sensation of 
chilliness, lasting from ten minutes to one hour, during 
which there is excessive thirst, nausea, and vomiting, 
mostly rejecting the fluids and medicine taken. There is 
intense fever with much tenderness of the Epigastrium 
and right Hypochondrium, which becomes painful upon 
pressure. The countenance is flushed, the eye has a wild 
expression, with a violent pain in the head, and in some 
cases delirium. The pulse is frequent, beating during the 
fever from 120 to 130 per minute. It is sometimes small 
and irregular, at others full and forcible. The tongue is 
mostly brown, with a dry streak through the middle. The 
bowels are costive, but, when acted upon, the discharges 
are black or yellow. The urine is scanty and muddy. 
These symptoms usually continue from six to ten hours. 

The febrile paroxysm is superseded by a gentle perspi- 
ration on the head and shoulders, rarely extending over 
the entire body. There is now a mitigation of all the 
paroxysmal symptoms ; yet there is by no means a perfect 
A pyrexia. The pulse is still quick and irritable, with 
Tinnitus Aurium, lassitude and much debility. This state 
is called the remission, and lasts from one to three hours, 



REMITTENT FEVER, 55 

when the febrile symptoms recur, and gradually increase, 
until they acquire their former intensity, and do not sub- 
side until after a period longer than that occupied by the 
first paroxysm. In the subsequent exacerbations, the 
symptoms all become aggravated, except the chill, which 
generally becomes less marked each succeeding paroxysm, 
These exacerbations generally occur in a double Quotidian 
form, although I have frequently observed them, both of 
single and double Tertian, and Quartan. 

TREATMENT. 

This fever, if timely treated, yields with much readiness 
to mild antiperiodic, and alterative remedies. As for 
instance, in the forming stage, combine thirty or forty 
grains of Cornine with equal parts of Euonymine divided 
into six powders, and give one every two or three hours, 
until a full antiperiodic and alterative impression is pro- 
duced. This, with rest, and free bathing, will generally 
arrest the disease. 

During the cold stage the patient should be placed in 
bed, and a hot pack be applied to the bowels, and also to 
the regions of the liver and spleen. Hot sinapisms should 
be placed along the spine and the calves of the legs, ex- 
tending to the ankles and feet. As soon as the fever 
makes its appearance, the sinapisms should be removed, 
and the packs changed to tepid ones. The body should 
be freely sponged in warm lye water, every hour or two, 
as long as the fever lasts. The head should be packed in 
towels wrung out of cold water, and from ten to twenty 
of the Intermittent drops be administered every half hour. 

These drops are composed of equal parts of fluid Ext, 
of Lobelia, Cypripedin and Scutellaria. 

If the stomach will not tolerate them, from one to ten 
drops of the Tinct. Teratrum Viride may be given every 
fifteen or twenty minutes, until the same effect is produced, 



56 REMITTENT FEVER. 

After the remission is fully established, the following 
antiperiodic compound may be given. 

R Quinine gr. xx. 

Phosphate of Iron gr. x. 

Ferrocyanide of Potassium gr. j. 

Mix, divide into six powders, and give one every two 
hours. 

Or, 

U Bebeerine gr. xx. 

Salicine * gr. xx. 

Viburin gr. xij. 

Mix, divide into six powders, and give one every three 
hours. If the exacerbation comes on before the pow T ders 
are all taken, give one eighth of a grain of Veratrine with 
each alternate powder, till the remission becomes distinct. 
Or give Tinct. of Yeratrum in quantity sufficient to sub- 
due the fever. If this antiperiodic should not completely 
arrest the disease, before repeating it, the bowels should 
be moved by giving one gr. of Jalapin, one half gr. of 
Phytolacca mixed with thirty grains of sugar, and given 
in three doses at intervals of one hour. If this should fail 
to produce Catharsis, give one teaspoonful of the fluid 
extract of Antibilious physic every half hour, accompanied 
with warm water injection until the bowels move freely. 
After which, give one of the above antiperiodic com- 
pounds as before. Or if the stomach become irritable, 

U Quinine * gr. xx. 

Cream of Tartar , gr. xxx. 

Simple Syrup gij. 

Mix, and give one teaspoonful every hour until all is taken. 
If the stomach still continues irritable, thirty drops of the 
Tinct. of Gelseminum, and one grain of Morphine, may be 
added to the above mixture. 

When the paroxysms are very severe, and accompanied 



CONGESTIVE EEVER. 5T 

by congestion of some of the vital organs, and the natural 
increased intensity of the next exacerbation would prove 
disastrous to the patient, a large and full dose of some 
antiperiodic, in connection with an intermittent, should be 
administered at once. As for instance, 

U Quinine gr. xx. 

Scutellarine ,. gr. x. 

Cypripedin gr. x. 

Mix, divide into three powders, and give one every hour 
until all are taken. Or if the approaching exacerbation 
is near at hand, they may be given at still shorter intervals. 

When the paroxysmal form of the fever is removed, 
little remains to be done, save to repair the local and con- 
stitutional injuries produced by the disease. To restore 
the deranged functions of the liver, one or two grains of 
Euonymine may be given night and morning. 

The tone of the stomach may be restored by adding 
fifteen grains of Hydrastin to one half pint of Simple 
Syrup, and one eighth of a pint of gin, of which one or two 
teaspoonfuls may be given before each meal. If there is 
a tendency to relapse, or if the disease assumes an inter- 
mittent form, as it frequently does, the antiperiodic altera- 
tive, and tonic course, should be pursued until the parox- 
ysms are arrested, and the causes removed. 



CONGESTIVE OR TYPHUS FEVER. 

Much diversity of opinion exists relative to this disease. 
Some regarding it as a Continued Fever, of a highly con- 
tagious character, while others consider it as one of the 
modifications of malarial fever, belonging to the intermit- 
tent family. 

The limits of this work not being sufficient to admit of a 
thorough investigation of this subject, the reader is re- 



58 CONGESTIVE FEVER. 

ferred to the American Eclectic Practice, by Jones and 
Morrow, for a more minute description of this disease. 

SYMPTOMS. 

It is preceded by languor, headache, disturbed sleep, 
loss of appetite, followed by chilliness, swollen tongue, and 
great debility. The bowels are costive, the urine scanty 
and high-colored, the countenance is dingy and heavy, the 
eyes watery, with congestion of the conjunctiva, which 
often extends to the nasal fossa and larynx. There is 
ringing in the ears, with Epistaxis, and sense of fulness in 
the Epigastrium. 

These symptoms continue for two or three days, wheir 
the teeth become covered with dark sordes, the pulse 
becomes compressible, and the countenance is of a flushed 
appearance. 

The debility becomes more marked from the tenth to the 
twentieth day, and the symptoms are all more aggravated. 

There is incoherent talking, and delirium ; the tongue 
becomes dark and dry, with tremor of the hands, and 
Subsultus Tendinum. The evacuations become involun- 
tary, with retention of the urine, and interrupted breath- 
ing. The surface is covered with cold sweat, and the 
patient expires. 

This fever lasts from ten to thirty days. It is frequently 
confounded with Typhoid Fever, from which, however, it 
may be distinguished, by the absence of petechia?, the 
costive state of the bowels, and swollen condition of the 
tongue. Also, it usually assumes a more intermittent or 
remittent type. 

Where congestive fever is about to terminate favorably, 
the symptoms are much milder than those described above, 
and from the tenth to the twentieth day there is a diminu- 
tion in the severity. 






CONGESTIVE FEVER. 59 

TREATMENT. 

There is generally more local congestion in this than 
any of the previous forms of fever, with almost a complete 
suspension of the assimilating functions. To remove the 
congestion, and restore the assimilatiug functions, is the 
prominent indication to be fulfilled. In the early treat- 
ment of this disease, hot packs should be applied to all 
parts of the body involved in the local congestion, except 
the head, which should be kept cool. For the purpose of 
restoring the assimilating functions of the stomach, pro- 
ducing intermission, and interrupting the paroxysmal cha- 
racter of the disease, the treatment should consist of those 
remedies possessing intermittent, antiperiodic, and stimu- 
lating powers, such as the following compounds : 

No. 1. R Quinine gr. xx. 

T. Xanthoxylin , gr. xx. 

Capsicum gr. x. 

Mix, divide into six powders, give one every three hours. 
Alternate each powder with ten or fifteen intermittent 
drops. 

Or, 

No. 2. R Quinine gr. xx. 

Capsicum gr. xx. 

Veratrin gr. ij. 

White Sugar gr. xx. 

Mix, and divide into ten powders, and give one every two 
or three hours. 
Or, 

No. 3. E Camphor gr. v. 

Quinine gr. xx. 

Viburine gr. x. 

White Sugar ; gr. xx. 

Mix, and divide into twenty powders, and give one every 
two or three hours. 



60 CONGESTIVE FEVER. 

Or, 

No. 4. j£ Eupatorine gr. xx. 

Ainuin .... , gr. xx. 

Aconitine gr. Iss. 

White Sugar gr. xx. 

Mix, divide into six powders, and give one every two 01 
three hours. 

Or, 

No. 5. R Scutellarine gr. xx. 

Chinoidin gr. xx. 

Oil Capsicum gutt. iij. 

White Sugar gr. xx. 

Mix, divide into eight powders, and give one every two 
or three hours. 

To act as an alterative after the fever is broken : 

R Euonymine gr. xx. 

Podophyllin gr. ij. 

White Sugar gr. xx. 

Mix, divide into ten powders, and give one every three 
hours. 

The bowels should be kept open, during the treatment of 
this disease, by giving small doses of neutralizing mixture 
and Euonymine, and the body should be freely sponged 
with lye water and whiskey. In cases where there is evi- 
dent derangement of the stomach, with costive state of the 
bowels, an emetic and cathartic should be given, previous 
to the administration of the antiperiodic powders. A 
teaspoonful of common emetic acetic Tinct. in warm 
ginger tea, may be given every ten or fifteen minutes, until 
the stomach is thoroughly evacuated. This should be 
followed by small doses of Podophyllin and neutralizing 
mixture, until free catharsis is produced. In cases where 
there are severe paroxysms, and the local congestion is 
likely to prove disastrous to the patient, the antiperiodic 



CONGESTIVE FEVER. 61 

should be administered first, and the emetic and cathartic 
should follow. 

But, whether the emetic and cathartic, or the powders 
be given first, if they fail to arrest the paroxysms, there 
should be a repetition of the antiperiodic powders after 
two or three days. During the interval, the patient 
should drink freely of some mucilaginous preparation, as 
marshmallow, flaxseed, or slippery elm. At the same 
time, if the skin be dry, from five to ten drops of Tinct. 
of Veratrum may be given to produce moisture. If, after 
pursuing the above course of treatment a week or ten 
days, the fever still proves persistent, the following com- 
pound may be given : 

U Ferri Ferrocyanide gr. xx. 

Quinine gr. xx. 

Piperine , gr. x. 

Gelsemin. '. gr. ij. 

White Sugar , gr. xxx. 

Mix, triturate, divide into ten powders, and give one 
every two or three hours. 

If, during the progress of the disease, there is trouble- 
some Epistaxis, a snuff of Matico leaves may be used, or 
an infusion of them may be injected into the nostrils. If 
there is much restlessness and inability to sleep, one-eighth 
of a grain of Hyosciamin, with Cypripedin and Scutel- 
larin, each one grain, given two or three times a day, will 
control the symptoms. Where there is tendency to syn- 
cope : 

R Carbonate of Ammonia gr. v. 

Gruni Camphor gr. v. 

Capsicum gr. x. 

Pulverized Acacia gr. xxx. 

Triturate, mix, and give one as often as indicated. 
During the treatment of this disease, the patient's strength 
should be maintained by a free use of beef tea, boiled 



TYPHOID FEVER. 



rice, and such other nutritious food as the stomach will 
tolerate. During the convalescence, a mild alterative and 
tonic course should be pursued. 



Thus far we have been treating of fevers which are ad- 
mitted to have their origin in marsh misasm, or are pro- 
duced by exposure to damp atmosphere contaminated by 
noxious gases, and decomposing vegetable matter, mostly 
affecting the spleen, producing Intermittent ; or, the spleen 
and liver, producing Remittent ; or, the spleen, liver and 
nervous system, producing Typhus or Congestive fever. 
But we now come to the treatment of a disease which is 
supposed to have its origin in both animal and vegetable 
miasm. And to confine its morbid influence mostly to the 
small glands of the bowels, producing more or less exten- 
sive ulcerations. This is called 

TYPHOID FEVER. 

This is a fever which has received quite a number of 
names. Such as Enteric fever, Continued fever, Bilious 
fever, Bilious Continued fever, and Nervous fever. But 
the name by which it is most commonly known is that of 
Typhoid Fever. 

SYMPTOMS. 

Few diseases are so remarkably insidious, in their ap- 
proach, as this fever; its commencement being almost 
imperceptible. Its incubation generally lasts from three 
or four days to as many weeks. The patient feels at first 
slight debility, with a dull and heavy feeling in the head, 
which continues to increase, terminating in violent frontal 
headache. By the time the disease becomes fully de- 
veloped, the limbs are weak, with lameness, and in some 
cases, rheumatic pains. The bowels are at first slightly 
constipated; but in the course of a few days, there is a 
strong tendency to diarrhsea. The pulse is accelerated, 



TYPHOID FEVER. 63 

and a creeping chilly sensation is felt, commencing in the 
back, and passing over the entire body. The chilliness is 
soon followed by a slight increase of all the symptoms, 
together with a dry and warm state of the skin. These 
partial paroxysms, frequently follow each other in rapid 
succession ; but sometimes there is an interval of several 
hours. The tongue is but slightly coated, and the appetite 
remains nearly natural until the disease becomes fully de- 
veloped. Indeed, in a large number of cases which have 
come under my observation, there is no anorexia during 
the entire progress of well-marked cases of this disease. 

About this time, there may be observed a number of 
small white vesicles or sudaminaB, at first mostly confined 
to the abdomen, but afterwards extending over the entire 
body. These sudaminae, although frequently appearing in 
other fevers, are more generally present in this. These 
vesicles, unless carefully observed, will escape notice, as 
they are frequently so small as to be scarcely perceptible 
to the naked eye ; being seldom larger than half the head 
of a pin. To the casual observer, they might easily be 
mistaken for partial, detached, dermoid scales. But when 
pricked with the point of a needle, a small quantity of a 
thin white fluid may be seen to escape. On the fifth day 
from the appearance of the sudaminaB, another eruption 
appears which is diagnostic of this disease. It is small, 
red, or purple spots or eruption, resembling flea-bites. 

At first they are very small, so small that without the 
aid of some magnifying power the larger portion of them 
cannot be seen. They are at first perceptible just above 
the ileo-caacal valve, or about one and one half inches 
above the crest of the ileum, and extend over all parts of 
the body* but are mostly confined to small patches of 
skin corresponding to the ulcerated parts of the bowels. 
These spots are called petechice. They are small circum- 
scribed red spots when fully developed. They may be 



64 TYPHOID FEVER. 

distinguished from most other forms of eruption, by dis- 
appearing on pressure, but returning again the moment 
the pressure is removed. They come and go, appearing 
and disappearing ; but their presence or absence during 
the active stage of the disease, is a sure index to the state 
of the bowels. As when the bowel symptoms are aggra- 
vated, the petechias disappear ; but when they become 
ameliorated, are again visible. This leads me to infer 
that Typhoid Fever, like Scarletina, is an eruptive disease, 
and that to maintain the eruption on the surface, is a very 
important indication to be fulfilled in its treatment. When 
the disease becomes fully developed, and in some cases, in 
the forming stage, the bowels yield a marked tympanitic 
resonance on percussion. 

On inspection, a bloated or tympanitic condition of the 
bowels may be observed, and most marked, beneath the 
patches of petechias. 

About this stage of the disease, the nervous symptoms 
become aggravated, amounting in many cases to delirium, 
and in others producing great pain in different parts of 
the body, as the knees, hips, abdomen, side and head. 
These pains are mostly transitory, or appear in the form 
of paroxysms. In a few cases the patient inclines to 
stupor, but generally the opposite is the case, the patient 
being restless and wakeful. There is a buzzing noise in 
the head, very much like that caused by full doses of 
Quinine. 

The tongue, by this time, mostly assumes a red appear- 
ance, especially upon the tip and edges, and the papillae 
become elevated. When it is protruded it may be seen to 
tremble, and in some cases it is protruded with much diffi- 
culty. The pulse increases in frequency, but diminishes in 
fulness ; and in the latter part of the disease it becomes 
very compressible. The eyes have a watery appearance, 



TYPHOID FEVER. 65 

and when the bowels become extensively ulcerated, they 
have a vacant stare and remain partly open during sleep. 

The breathing is laborious, the mouth is half open, and 
sordes accumulate upon the teeth. The urine, which was 
somewhat scanty, now becomes nearly suppressed, having 
a dark red appearance, generally containing a large per 
cent, of albumen. The bowels continue to bloat, the 
evacuations are frequent, sometimes watery and frothy, at 
other times dark and offensive, and mixed with blood : or, 
the entire discharge may consist of blood amounting to 
active hemorrhage ; being mostly of a dark venous charac- 
ter, although I have seen it of a bright red color, or of 
the appearance of fresh arterial blood. This symptom, 
although alarming and dangerous if persistent, is fre- 
quently followed by speedy recovery. The skin is not 
as dry and hot as in many fevers, yet it is frequently 
pungent, and has a husky feeling. The pulmonary organs 
generally sympathize with affections of the bowels, and 
especially is it the case in this disease. Hence we find 
Crepitant Rhonchus, and frequently a slight cough. If 
the disease is about to terminate fatally, the symptoms 
will continue to increase in severity, the patient will 
become stupid with low muttering delirium, subsultus ten- 
dinuin, picking at the bed-clothes, coma, and death. Or 
frequently the ulceration of the bowels may terminate 
in perforation, followed by a discharge of the contents 
into the cavity of the abdomen, producing at first much 
pain, but soon subsiding, the patient becomes covered 
with a cold clammy sweat, the pulse ceases at the wrist, 
the bowels evacuate involuntarily, and the patient sinks 
into the arms of Death. 

Or what is more frequently the case, where mischievous 

medication has been avoided, the symptoms will continue 

in a somewhat modified form from fourteen to twenty-one 

days, when they gradually become ameliorated, and the 

G* 



66 TYPHOID FEVER. 

patient recovers. The average mortality of this disease 
is only about 10 per cent, or from 15 to 20 per cent, less 
than it is under Allopathic treatment. 

TREATMENT. 

In no disease is there more mischief done by an im- 
proper course of medicine than in this. 

The practice of giving active purgative medicine in th( 
commencement of a fever, with the notion of puking and 
purging it from the system, has increased the mortality to 
an alarming extent. For after a drastic purgative, it is 
almost impossible to cure Typhoid Fever, no matter how 
prudent your after course may be. First, in the treatment 
of this disease, the skin should be thoroughly bathed in 
warm lye water and whiskey. The patient should then be 
placed in bed, when, if the bowels are costive, they should 
be moved by warm water injections. If the stomach con- 
tains indigestible food, or if there should be a marked in- 
dication for an emetic, one-eighth of a grain of Lobelin 
may be given in a wine-glass of warm ginger tea every ten 
or fifteen minutes, until the stomach is thoroughly evacua- 
ted. After this the patient should drink freely of beef tea 
and rice gruel. When the stomach becomes settled, or the 
effect of the emetic has passed off, give from one to five 
drops of the Tinct. of Aconite in a tablespoonful of water 
every half hour, until the pulse becomes less frequent and 
the skin moist. At the same time apply warm lye poul- 
tices to the bowels, made by adding one teaspoonful of 
mustard-seed to ten tablespoonfuls. of slippery elm, wet 
with strong saleratus water. These poultices should be 
changed as often as three or four times a-day, and con- 
tinued as long as the bowel symptoms prove troublesome. 

When the pulse becomes controlled by the Aconite, the 
next thing is to interrupt the periodicity of the disease, by 
giving the following antiperiodic. 



TYPHOID FEVER. 6t 

U Quinine gr. xx. 

Hydrastin .., gr. xx. 

White Sugar gr. xxxx. 

Mix, divide into six powders, and give one every three 
hours until all are taken. 

At the same time, give freely of mucilage, such as a 
cold infusion of pulverized marshmallow, acacia, or flax- 
seed. Also apply water to the head. If the patient is 
of a bilious temperament, and full habit, the water should 
be cold. If of a nervous temperament, with low vitality, 
the water should be tepid, and mixed with a little whiskey. 
The feet should be kept warm, and the patient remain 
quiet in bed. At the same time give a sufficient quantity 
of Aconite to control the fever, and to maintain the 
petechia upon the surface. If there should be diarrhoea, 
small doses of equal parts of Erigeron and Rhusine should 
be given two or three times a-day. If the patient be rest- 
less and unable to sleep, from the sixteenth to an eighth 
of a grain of Morphine may be mixed with one or two 
grains of Cypripedin, and given at bed-time. If the 
diarrhea proves persistent, in addition to the Khusine and 
Erigeron, injections should be given two or three times a- 
clay, composed of from four to six ounces of starch-water, 
half a grain of Morphine, and from five to ten grains of 
Tannin. If the Aconite fail to maintain the petechias 
upon the surface, one half grain of Macrotin should be 
given in connection with it. If, after pursuing the above 
treatment for six or seven days, the disease should not be 
arrested, the antiperiodic should be repeated by giving the 
following compound : 

U Phosphate of Iron gr. x. 

,Quinine gr. xx. 

PJmsine gr. xx. 

White Sugar gr. xxxx. 

Triturate, mix, and divide into six powders, and give one 
every three hours until all are taken. 



68 TYPHOID FEVER. 

At the same time, the Aconite and anti-diarrhaea medi- 
cines should be given if indicated. If the bowels should 
become persistently tympanitic, with extensive ulceration, 
the Tinct. Bryonia should be substituted for the Aconite, 
and the patient prohibited from assuming the upright pos- 
ture, as in all such cases there is great danger of perfora- 
tion. Where there is much debility, a permanent tonic 
may be given in connection with Chalybeates, such as the 
following compound : 

R Iron per Hydrogen gr. xx. 

Hydrastin gr. xx. 

White Sugar gr. xxx. 

Triturate and mix, divide into ten powders, and give one 
every two or three hours, during the interval between the 
antiperiodic medicine. 

During the entire course the patient's strength should 
be maintained by a free use of the Essence of Beef, made 
by adding one pound of beef to one quart of water and one 
half pint of vinegar. Boil the beef till the liquid is one 
half evaporated. Then strain ; add one pound of White 
Sugar and eight ounces of rice flour, boil fifteen minutes, 
strain again, add one half pint of best Old Whiskey, one 
tablespopnful of salt, and bottle for use. Give the patient 
from one half to one wine glass full four or five times a-day. 
Also Porter or Scotch Ale, toast, or broiled beef may be 
allowed when the stomach will tolerate it. In the event 
that the medicine already prescribed fails to maintain the 
petechias upon the surface, the Tinct. of Scrophularia may 
be given to the amount of twelve drops three or four times 
a day. If necessary to restore the eruption, hot brandy 
toddy may be given in connection with the above. If 
symptoms of softening of the brain appear, from one to 
five drops of Tinct. Phosphorus may be given two or three 
times a-day in a large quantity of mucilage. If dangerous 
hemorrhage from the bowels occur : 



YELLOW FEVER. 69 

R Nitrate of Silver gr. x. 

Pulverized Acacia gr. xxx. 

Pulverize, mix, make sixteen pills, and give one every 
hour until all are taken, or until the hemorrhage is con- 
trolled. Or give from ten to fifteen grains of Matico every 
three or four hours. If an alterative is indicated, small 
doses of Leptandrin may be given three or four times a clay. 
Where the disease is firmly established, much care must be 
observed relative to the administration of medicine, never 
giving any, unless some marked indication demands it ; 
frequently all the medicine necessary is a few drops of 
Aconite two or three times a-day, with a liberal quantity 
of mucilaginous drinks, one or two courses of antiperiodics, 
and a liberal supply of food. Yet where there is a 
decided indication for treatment, it should be met with 
promptness. During convalescence, small doses of Hy- 
drastin, in connection with Chalybeates, should be ad- 
ministered. 



YELLOW FEVER, OR TYPHUS 
ICTERODES. 

This disease prevails endemically in tropical climates, 
but only appearing at the North as an epidemic. It is 
generally supposed to have a compound origin arising 
from the effects of animal and vegetable miasm. 

SYMPTOMS. 

The premonitory symptoms very much resemble those 
of Typhoid Fever, except that they are more rapid in their 
course. The skin is hot and dry, the face flushed, the 
respiration hurried, the eyes are red and watery, and there 
is nausea and vomiting. As the disease advances, these 
symptoms all become aggravated, and the diagnostic 
symptoms make their appearance. 



10 YELLOW FEVER. 

The countenance assumes a peculiar cadaverous expres- 
sion, and is of a bright saffron color. The tongue is soft 
and swollen, and there is pain in the Epigastrium. During 
the progress of the disease, the symptoms are variable in 
different individuals and localities, sometimes running an 
exceedingly mild course, with little more severity than ordi- 
nary Remittent Fever, while in other cases the disease is 
marked with great prostration. In the first stage the pulse 
sinks, there is nausea, and vomiting of a dark frothy fluid ; 
the respiration is exceedingly difficult and hurried. There 
is also low muttering delirium. The alvine evacuations 
are large and dark, the patient rapidly sinks, and death 
soon relieves him, unless the disease is arrested by timely 
treatment. 

TREATMENT. 

The first thing to be done in the early stage of the dis- 
ease is to give a stimulating emetic : 

U Pulverized Lobelia gr. x. 

" Bloodroot gr. xij. 

" Capsicum gr. xx. 

Mix, add one gill of warm water, steep fifteen or twenty 
minutes, and after giving the patient three or four wine- 
glasses full of warm ginger tea, give one teaspoonful of the 
mixture, and repeat until a thorough evacuation of the 
stomach is produced. 

Immediately after the emetic, give a spirit vapor-bath 
by placing a blanket about the patient and chair, and burn- 
ing a cup of alcohol beneath it, to produce a copious per- 
spiration : at the same time give the patient freely of 
weak salt and water to drink. After the sweat, a thorough 
bathing and rubbing will prepare the patient for bed. The 
following compound may then be given : 

R Quinine gr. xx. 

Chloride of Sodium gr. xxx. 

Capsicum ., gr. x. 



YELLOW FEVER. Tl 

Mix, divide into eight powders, and give one every three 
hours until all are taken. At the same time, warm poul- 
tices should be applied to the abdomen and stomach, and 
hot sinapisms to the feet and calves of the legs, and a 
warming plaster along the spine. 

When the antiperiodic mixture has been taken, the fever 
and circulation should be controlled by the use of Aconite, 
and rest should be induced by giving Cypripedin and Scu- 
tellaria or by small doses of Morphine. The bowels should 
be moved by the following alterative : 

R Euonymin gr. x. 

Jalapin „ gr. ij. 

Xanthoxylin gr. x. 

White Sugar , gr. xxx. 

Triturate, mix, divide into six powders, and give one every 
two or three hours. 

If there is much nausea and vomiting, the following 
compound may be given : 

B Vinegar . Oss. 

Common Salt gj. 

Capsicum gr. xx. 

Mix, and give one teaspoonful every ten or fifteen minutes, 
as the symptoms may indicate. If the disease should not 
yield to the above treatment, within the course of three or 
four days, the following antiperiodic should be adminis- 
tered : 

B Salicine gr. xxx. 

Quinine , gr. xv. 

Iron by Hydrogen gr. xx. 

Capsicum gr. x. 

Mix, divide into six powders, and give one every three 
hours. At the same time give the patient freely of Ess. 
of Beef as directed under Typhoid Fever. Once or twice 
a day the patient should be bathed with warm lye water, 
and allowed to drink of porter or good ale, whenever 



12 INFLAMMATION. 

the active fever does not contra-indicate. Local congestion 
or inflammation should be relieved by hot or cold packing, 
as the case may require. During the convalescence, altera- 
tive doses of Podophyllin, with Hydrastin as a tonic, may 
be given once or twice a day, together with a free and 
generous diet. If there should be symptoms of a relapse, 
the antiperiodic remedies should be repeated. 



INFLAMMATION. 

Inflammation is always located in the capillary vessels. 
Hence, tissues destitute of these vessels are never capable 
of taking it on, as the hair, nails, cuticle, and enamel. 

Filamentous tissues, on the other hand, as the liver, 
lungs, and mucous and serous membranes, are very liable 
to inflammation. The first step towards the inflammatory 
process is an accumulation of blood, which is congestion. 
This accumulation may occur either from too slow venous 
or too rapid arterial circulation. Or it may arise from 
debility of the capillary vessels, or from all these causes 
combined. The congestion may disappear by a diminu- 
tion in the afflux, together with a restoration of the normal 
functions of the capillaries. Or it may terminate in inflam- 
mation by the blood beginning to oscillate in the vessels, 
adhering at different points until finally it stagnates. 

The blood failing to be converted into venous blood, its 
coagulability is increased so that the globules coalesce and 
form minute clots. New vessels or canals are formed by 
globules of blood bursting the vessels and passing into the 
adjacent parenchyma, reaching another vessel, thus form- 
ing new passages through the areolar tissue, which ulti- 
mately become capillary tissue. Or the corpuscles may 
remain in the adjacent parenchyma, producing swelling by 
effusion. In active congestion, the contractile powers of 
the vessels are lost by over-distension, the blood stagnates, 



INFLAMMATION. T3 

the coats of the capillaries become diseased and ruptured, 
resulting in extravasation or effusion of blood, coagulable 
lymph, and serous or ruuco-purulent fluid. 

THE SYMPTOMS 

Are redness, swelling, pain, and increased heat. The 
redness is owing to an increased accumulation of blood in 
the part. The swelling to infiltration, to accumulation of 
blood and pus, and to oedema of the lymphatics. The 
pain is produced by the tension, and the pressure made on 
the nerves of the parts, with the increased sensibility. The 
heat is caused by oxydation of effete matter and adipose 
tissue, and retention of natural animal heat. 

The termination of inflammation is 1st, resolution ; 2d, 
suppuration ; 3d, mortification. 

Resolution may be preceded by Metastasis, as in mumps 
or rheumatism. The symptoms which precede resolution 
are increased perspiration, diarrhaea, changes in the urine, 
and hemorrhage. In effusion, we have formation of false 
membrane, as in croup. Suppuration is the conversion of 
coagulable lymph into pus. Mortification, Gangrene, or 
Sphacelus, is the complete death of the part. 

TREATMENT. 

The first indication to be fulfilled in the treatment of 
inflammation, is to equalize the circulation, and restore 
the lost functions of the capillaries. 

Veratrum, Aconite, and Gelseminum, with the ligature, 
will enable us to control the circulation. While Podo- 
phyllin, Jaolapin, with Bitartrate of Potassa, will relieve 
the vessels of the plethora, if that should be a cause of the 
disease. 

But as the treatment of inflammation depends in a great 
measure upon its locality, the remedies will be given under 
the head of inflammation of the different tissues. 
t 



74 PURE NIT IS. 



PHRENITIS, OR ENCEPHALITIS, AND 
MENINGITIS; 

(OR INFLAMMATION OF THE BRAIN AND ITS MEMBRANES.) 
SYMPTOMS. 

A vague uneasiness of the mind, defective appetite, 
dizziness with vertigo. The pulse is hard and bounding, 
the eyes have a wild and anxious expression. The patient 
complains of great debility, and a sense of numbness in 
one side of the body ; the numbness being on the opposite 
side from the location of the disease, and the patient lies 
mostly on the back. There is ringing in the ears, which 
very much increases as the disease advances. In the early 
stage of the disease, the pupil of the eye is preternaturally 
contracted ; but in the latter stage, the pupil is much 
dilated, and light becomes intolerable. 

As the disease advances, there are convulsive muscular 
movements, with more or less delirium. The respiration 
is irregular, the skin hot, there is nausea and vomiting, 
the bowels are confined, and in most cases there is obsti- 
nate costiveness. These symptoms may all become aggra- 
vated, terminating in subsultus, picking at the bed-clothes, 
stupor, coma, suppression of the urine, colliquative sweat, 
stertorous respiration, and death. 

Or the symptoms may all become ameliorated, and the 
patient recover. 

CAUSES. 

1. Accidents. 2. Intemperance in eating and drinking. 
3. Metastasis of inflammation from other parts. 4. 
Mental excitement. 5. Exposure to atmospheric vicissi- 
tudes. 6. Animal and vegetable misasim 



PHRENITIS. ?5 



TREATMENT. 



After due attention to the cause of the disease, the 
bowels should be thoroughly evacuated, by giving the 
following compound : 

U Podophyllin gr. ij. 

Jalapin gr. j. 

White Sugar gr. xx. 

Mix, divide into eight powders, and give one every hour 
until they act as a liberal purgative. At the same time 
apply ligatures to the legs and arms by placing a bandage 
around them sufficiently tight to prevent the return of the 
blood by the veins, but allowing it to pass into the limbs 
through the arteries. Care should be taken not to pro- 
duce complete syncope ; but'the ligatures should be used 
sufficiently to deplete the brain and thereby relieve the 
distended capillaries. The ligatures should be tightened 
or loosened according to the emergency of the case and 
the indication to be fulfilled. In removing them, much 
care should be taken to loosen them one at a time, and at 
sufficient intervals to allow the blood to return to the body 
by degrees. At the same time cold packs should be ap- 
plied to the head, and changed sufficiently often to keep 
them cool. A warm sinapism should be placed along the 
spine, and the patient caused to take Aconite until a free 
diaphoresis is produced. The surface should be freely 
bathed in strong lye water two or three times a day, to- 
gether with hot foot-baths. 

If the disease does not yield to the above treatment, the 
purgative should be repeated. 

After wmich the following compound should be given : 

R Digitalin , gr. j. 

Sanguinarin gr. ij. 

White Sugar gr. xx. 

Mix, divide into eight pow T ders ; and give one every two 



76 THRUSH. 

or three hours. If there be periodicity connected with 
the inflammation, give the following compound : 
R Quinine , gr. x. 

Phosphate of Iron gr. xx. 

Veratrine gr. j. 

White Sugar , gr. xx. 

Mix, triturate, divide into ten powders, give one every 
two or three hours as may be indicated. During the 
treatment, the patient should be kept quiet, and in bed, 
and recourse should be had to the ligature, when the 
determination of the blood to the head should indicate it. 
The diet should be principally fluid, and of easy digestion, 



THRUSH, INFANTILE SORE MOUTH. 

This disease mostly occurs in children from one to three 
months old. 

CAUSES. 

Unhealthy milk and an accumulation of effete matter 
and lactic acid, which comes in contact with the mucous 
surface of the child's mouth, while nursing, producing 
abrasion. 

SYMPTOMS. 

Small white specks appearing, either single or in clusters, 
having a dark and inflamed base, which continues to spread 
and coalesce until the entire mucous surface is involved in 
the disease. 

TREATMENT. 

Remove the cause. Bathe the breast frequently in weak 
lye water, and thoroughly cleanse the nipple each time 
before the child nurses, and give the following compound : 

R Hydrastin gr. x. 

Rhusine gr. x. 

Neutralizing Mixture Jij. 



FOLLICULAR STOMATITIS. TT 

Give the child from fifteen to twenty drops two or three 
times a day ; also wash the mouth in a weak solution of 
Hydrastin. 



FOLLICULAR STOMATITIS, OR 
NURSING SORE MOUTH. 

Symptoms are transparent whitish vesicles on elevated 
salivary glands. The vesicles break, and the fluid denudes 
the mucous surface of the Epithelium, causing inflammation 
and ulceration, the ulcers often extending over the entire 
mouth, and in some instances to the (Esophagus and 
stomach, producing general constitutional disturbance. 

TREATMENT. 

U Neutralizing Mixture. gij. 

Salicine gr. xxx. 

Rhusine gr. xx. 

Mix, give one teaspoonful every. two or three hours during 
the day. The mouth should be washed in a strong solution 
of Hydrastin both before and after each meal. 

If the disease does not yield to the above treatment, the 
following antiperiodic and tonic should be given : 

R Myricin ? gr. xx. 

Cornine gr. x. 

Iron by Hydrogen gr. x. 

White Sugar , gr. xxx. 

Mix, divide into ten powders, and give one every three 
hours ; after which give the following mixture : 
U Neutralizing Mixture giij. 

Myricin gr. x. 

Helonin gr. xx. 

Mix, give one teaspoonful three times a day. 

If there is debility, give the gin bitters of the American 
Eclectic Dispensatory in quantities indicated. 
7* 



78 QUINSY. 

The surface should be bathed every day in warm lye 
water. The diet should consist of animal broths ; broiled 
beef, rice, bread and milk, &c. 



QUINSY— CYNANCHE TONSILLARIS. 

SYMPTOMS. 

The parts involved in this disease are the tonsils and 
adjacent mucous surface. They appear red and swollen. 
The patient complains of great pain and difficulty in swal- 
lowing. The pulse becomes quick and hard, and the 
breathing nasal and laborious. 

These symptoms are generally preceded by rigors or 
chills, alternated with flashes of heat. The tongue is 
covered with a light coat, the bowels are confined, the 
eyes are suffused and red, and the face swollen. As the 
disease advances the swelling increases, and the patient 
expectorates a thin viscid mucus. The throat, ears and 
eyes become painful, the breathing and deglutition more 
difficult, and the patient is compelled to assume the erect 
position on account of the great dyspnoea. 

TREATMENT. 

The patient's feet should be placed in hot water, and, in 
the early stage of the disease, a sufficient quantity of the 
acetic emetic Tinct. should be given to produce free emesis. 
After which the surface should be thoroughly bathed i n 
warm saleratus water, and the patient placed in bed, with 
jugs of warm water to the feet, and an onion poultice to 
the throat. If there is much fever, from three to five 
drops of the Tinct. of Yeratrum should be given from 
every half hour to an hour; until the fever subsides. 

At the same time the throat should be thoroughly 
washed by means of a probang, with a weak solution of 



OTITIS. 19 

nitrate of silver and Hydrastin. The bowels should be 
opened by small doses of Podophyllin and antibilious 
physic. If the swelling produces dangerous dyspnoea, the 
tonsils should be freely scarified with a sharp-pointed bis- 
toury, and a strong solution of sulphate of zinc applied by 
means of the probang. Also apply to the throat, before 
the application of each onion poultice, a liniment com- 
posed of equal parts of Acetic Tet. of Beef's Gall, Gelse- 
minum and Camphor. The patient should be kept quiet, 
and during convalescence the diet should be light and 
nutritious. 



OTITIS, OR INFLAMMATION OP 
THE EAR. 

CAUSES. 

Local injuries, Scarlet Fever or inflammation of the 
Eustachian Tubes. 

SYMPTOMS. 

Pain, ringing in the ears, &c. Diagnosis is easily made 
with the Speculum. 

. TREATMENT. 

Remove the cause, after which apply hot packs to the 
ear, and introduce lint, saturated with equal parts of Tinct. 
of Lobelia and Aconite. If there are constitutional symp- 
toms, give a mild purgative of Euonymine and neutralizing 
mixture. If there is fever, give Eupatorin one or two 
grains three or four times a-day ; also from five to ten 
drops of the Tinct. of Gelseminum every two or three 
hours until the fever abates. If there is ulceration, use a 
mild zinc wash ; Compound Syrup of Stillingia, given in 
quantities sufficient to act as a mild alterative, will 
generally be adequate to a cure. 



80 GASTRITIS. 

GASTRITIS, OR INFLAMMATION OP 
THE STOMACH. 

SYMPTOMS. 

Vomiting, great thirst, precordial distress, a quick and 
hurried pulse, tenderness in the Epigastrium, with the 
tongue mostly dry and hard and the papillae elevated. The 
skin is hot and dry, the urine scanty, and the bowels con- 
stipated. As the disease advances, the patient is restless 
and peevish, the countenance has a distressed, shivered and 
anxious appearance. 

The nausea becomes constant, and every substance taken 
into the stomach is immediately rejected. The appearance 
of the rejected contents of the stomach is at first a greenish 
mucus, mixed with the ingesta ; but if the disease is 
about to terminate in mortification, and death, they will 
become dark, and will finally have the appearance of coffee 
grounds. 

CAUSES. 

Worms, irritating substances taken into the stomach, or 
as is more frequently the case, it is one of the local symp- 
toms of idiopathic fever. 

TREATMENT. 

After giving due attention to the cause of the disease, 
the feet should be placed in warm water, and the entire 
surface of the body thoroughly bathed in broke water and 
whiskey. After which, from one to ten drops of the Tinct. 
of Aconite should be given every fifteen or thirty minutes 
until a gentle perspiration is produced. 

At the same time, the bowels should be evacuated by 
means of stimulating injections, and warm sinapisms 
applied to the Epigastrium. 

After continuing the above treatment for five or six 



DYSPEPSIA, 81 

hours, if the symptoms do not yield, the Tinct. of Bryonia 
may be substituted for the Aconite, and the patient caused 
to drink freely of mucilage, as Gum Arabic, Slippery Elm, 
Flaxseed, &c. 

The sinapisms should be removed after having caused 
irritation, and hot packs applied in their place. 

If, after pursuing the above treatment for ten or twelve 
hours, the inflammation still proves persistent, and the 
cause of the disease has been removed, a thorough spirit- 
sweat should be given, and the hot packs continued, and 
warm sinapisms applied to the feet. Also from one to five 
drops of the Tinct. Rhus Radicans given every hour until 
the disease becomes mitigated. 

If it assumes an intermittent form, some of the anti- 
periodic compounds should be administered by means of 
starch-water injections, sufficiently to arrest the disease. 

The diet should be fluid, but nutritious. 



DYSPEPSIA, OR INDIGESTIOX, 

CAUSE. 

Debility of the stomach, and whatever prevents a normal 
secretion of gastric fluid. 

SYMPTOMS. 

Pain in the stomach after eating, palpitation of the 
heart, sharp and pinched features, furred tongue, irritable 
temper, wakefulness, a costive condition of the bowels, 
dry and husky skin, and debility. 

TREATMENT. 

B Populin gr. xx. 

Sangumarin , , gr. x. 

"White Sugar. gr. xxx. 



82 ENTERITIS. 

Triturate, mix, divide into sixteen powders, and give one 
four times a day. After which, 

R Hydrastin gr. xxx. 

Syrup of Sugar , Oss. 

Muriated Tinct. of Iron gj. 

Mix, and take one teaspoonful three times a day before 
meals. 

If the above prescriptions do not give relief, the follow- 
ing compound may be administered : 

U Neutralizing Mixture , Oss. 

Aletrin gr. x. 

Chloride of Sodium gss. 

Mix, and give one teaspoonful three times a day. 

A mixture of animal and vegetable diet should be taken 
at regular intervals, and thoroughly masticated. 

A free state of the bowels should be maintained by the 
use of bran-water, salt and water, ripe fruit, etc. ; and the 
surface should be sponged several times a week in cold 
or warm water, as circumstances indicate. 



ENTERITIS, OR INFLAMMATION OP THE 
SMALL INTESTINES. 

In simple Enteritis, there is deep-seated pain in the 
umbilical region, and sometimes in other parts of the intes- 
tinal tubes. The pain is more or less constant, yet it is 
subject to paroxysmal aggravations, and is increased by 
pressure. The patient manifests restlessness by constant 
motion of the arms and legs. As the disease advances, 
the pulse becomes hard and wiry, the skin dry, and some- 
times pungent, the tongue is covered with a dark brown 
coat ; and in later stages, there is diarrhea and a bloated 
condition of the bowels. 



DYSENTERY. 83 

TREATMENT. 

The stomach should be thoroughly evacuated by Lobelia 
and Sanguinaria, in quantities sufficient to produce active 
emesis. As soon as this is effected, give a spirit vapor- 
bath, and wash the patient in strong saleratus water. A 
sinapism should be placed over the bowels, and Aconite 
administered in one or two-drop doses every ten or fifteen 
minutes until free diaphoresis is produced. If the symp- 
toms should not become mitigated in ten or fifteen hours, 
the following antiperiodic should be given : 

R Gelsemin gr. i. 

Sanguinaria gr. x. 

• White Sugar gr. xxx. 

Triturate, mix, divide into ten' powders, and give one every 
two or three hours. At the same time, if the fever prove 
obstinate, one or two drops of the Tinct. of Bryonia may 
be given between each powder. 

When the sinapism has produced free counter-irritation, 
warm packs may be applied to the bowels. 

If the disease assumes a periodic character, some of the 
antiperiodic mixtures should be given. The convalescence 
should be carefully watched, and the diet well regulated. 



DYSENTERY, OR COLITIS, (AN INFLAMMA- 
TION OF THE COLON). 

SYMPTOMS. 

Acute dysentery commences with uneasiness, soreness, 
and sense of weight in the lower part of the bowels, and a 
constant desire to go to stool. 

In the course of from five to twenty-four hours, the 
diarrhoea is changed to mucus mixed with blood. As 
the pain and tenesmus "increase, the skin becomes hot and 
dry, the urine red and scanty, and not unfrequently there 
is much pain in micturition. 



84 DYSENTERY. 

The tongue is covered at first with a light coat, which 
soon becomes heavy and of a dark brown color. The 
pulse varies in frequency and fulness according to the seve- 
rity of the case. In children, there are more or less brain 
symptoms, which not unfrequentiy prove the most obstinate 
feature of the case. 

CAUSES. 

In children the disease is not unfrequentiy caused by 
ascaricles in the lower portion of the rectum. Also by 
anything which tends to obstruct the portal circulation, 
and causes a sudden determination of the blood from the 
superficial capillaries to the deep capillaries of the bowels. 

TREATMENT. 

To ascertain the cause, and as far as possible to remove 
it, are the first things to be done in the treatment of this 
disease, as well as all others. 

If the tongue is coated, and the stomach in a condition 
to indicate it, an emetic of Emetine or Lobelia may be 
given. During the operation, the patient should drink 
freely of some warm aromatic tea. 

As soon as the effect of the emetic has passed off, the 
spirit vapor-bath should be given ; after which the surface 
should be thoroughly bathed in warm lye water, and the 
patient placed in a recumbent position in bed. 

If there is obstruction of the portal circulation from con- 
gestion of the liver or otherwise, the following purgative 
should be given : 

R Podophyllin , , gr. x. 

Neutralizing mixture giij. 

Pulv. Acacia gr. x. 

Mix, and give one teaspoonful every half hour until free 
catharsis is produced. Afterward give the following anti- 
periodic : 



DYSENTERY. 85 

R Chloride of Sodium ^j 

Quinine gr. x. 

Oil of Gaultheriae gutt. vi. 

Triturate, divide into ten powders, and give one every two 
or three hours until all are taken. 

During the administration of the powders, if there is 
much tenesmus, injections of starch-water, to which are 
added two or three grains of Tannin, and from one-fourth 
to one-half a grain of Morphine, should be given every five 
or six hours. 

If there is frequent pulse, connected with fever, Aconite 
or Veratrum should be given in sufficient quantities to 
maintain a gentle moisture of the skin. 

If, after giving the antiperiodic, the passages should 
still be frequent and painful, the following compound may 
be given : 

U Neutralizing Mixture §ij. 

Myricin and Rhusin ; aagr. x. 

Morphine gr. ij. 

Ess. of Anise gi. 

Mix, and give from one-half teaspoonful to a teaspoonful 
every two or three hours, as the case may indicate. 

Also apply the following liniment to the abdomen : 

R Chloroform gjss 

Tct. of Camphor gij. 

Oil of Olives giij. 

Mix, and apply to the bowels four or five times a day, 
followed by the application of hot dry flannel. 

If the passages should be large and consist principally 
of blood, from five to ten drops of the oil of Erigeron 
should be given every two or three hours, in connection 
with the above treatment. 

Where brain symptoms prove troublesome, the bowels 
should be kept open, and a free use made of Capsicum, 
8 



86 ACUTE PERITONITIS. 

and diuretics, in connection with the other remedies. If 
there is heat in the head, cold packs should be applied, 
also sinapisms to the back of the neck. 

The diet should consist of beef tea, boiled rice, soft 
ripe fruit, and such other articles of food as the condition 
of the patient may indicate. The convalescence should 
be watched with great care, as regards both diet and 
exercise. 



ACUTE PERITONITIS, OR INFLAM- 
MATION OF THE PERITONEUM. 

SYMPTOMS. 

There is a sharp pain in the abdomen over the region 
of the part inflamed. Soon after the first attack, there is 
generally more or less of a chill, followed by a decided 
-reaction and fever. The pulse soon becomes quick, wiry, 
and weak, and the tongue is covered with a light brown 
coat. The abdomen is tympanitic, and frequently there is 
nausea and vomiting. The patient assumes a recumbent 
position, as pressure causes much pain. The skin is 
hot and dry, the urine generally scanty and high-colored. 
As the disease advances, the extremities become cold, the 
eyes have a peculiar anxious expression, the body is 
covered with a cold clammy sweat, and the patient ex- 
pires. Or these symptoms may all become ameliorated, 
and result in gradual recovery. 

TREATMENT. 

U Podophyllin gr. i. 

Ext. of Anti-Bilious Physic gi. 

Mix, and give one teaspoonful every fifteen minutes, until 
it operates as a cathartic. After which, give the following 
antiperiodic : 



PNEUMONIA. 8Y 

U Quinine « gr. xx. 

Gelsemin gr. i. 

Capsicum gr. xx. 

Mix, divide into six powders, and give one every three 
hours, until all are taken. At the same time, if there is 
fever, give Aconite sufficient to control it. Also apply a 
poultice to the abdomen, made of one pint of oil meal, 
and one tablespoonful of mustard, wet with warm water, 
and change as often as becomes necessary, to keep up a 
gentle irritation of the surface. 

If, after the antiperiodic has been given, the symptoms 
still prove persistent, the cathartic should be repeated, 
followed by the Muriated Tinct. of Iron, from five to ten 
drops every two or three hours until the symptoms abate. 

The above treatment, together with frequent bathing of 
the surface, is generally sufficient to control the disease. 



PNEUMONIA, OR INFLAMMATION OF 
THE LUNGS. 

SYMPTOMS. 

The most prominent is a cough, with difficulty of 
breathing, followed by a hot skin, and increased fulness 
and frequency of the pulse. 

In the second stage the cough becomes loose, and the 
expectoration free and copious, having a rusty appearance 
and being at times mixed with blood. 

In the third stage, the Sputa assumes more of a purulent 
appearance, and the respiration is sufficiently hurried to 
produce more or less Dyspnoea. 

The physical signs are Crepitant Rhonchus in the first 
stage, Tabular or Bronchial Rhonchus in the second stage, 
and when there is Hepatization in the third stage, there 
will be either blowing tubular, sniffling metallic, or 



88 PNEUMONIA. 

Crepitant Bhonchus, also dulness on percussion. If there 
is pulmonary abscess, there will be amphoric tubular, or 
crack-metal rhonchus. The vocal resonance will be either 
bronchophonous or pectoriloquous. 

The varieties of pneumonia are numerous. At one 
time, it is marked by highly inflammatory symptoms ; at 
another, it assumes more of a Typhoid character, and 
being connected with great debility, the entire phenomena 
of the disease resembles that of incipient Phthisis. 

The prognosis of pneumonia, is altogether dependent 
upon the treatment. The mortality under Allopathic 
treatment being from fifteen to thirty per cent., while 
under a judicious Eclectic course, it scarcely amounts to 
one half of one per cent. 

TREATMENT. 

The prescriptions for simple sthenic pneumonia, are 
easily indicated ; very few medicines being required. 

The patient should be put upon the Tinct. of Veratrum 
Viride, in quantities sufficient to control the inflammatory 
action. In adults of full and plethoric habit, from five to 
ten drops may be given every half hour, until the inflam- 
matory stage has passed. 

A large cold pack may also be applied to the chest. 
When the inflammation has subsided, expectoration may 
be facilitated by giving equal parts of the Syrup of Lo- 
belia and Sanguinarin, every two or three hours. 

If there is periodicity to the disease, after the active 
stage has passed, Ceracine and Cornine may be given in 
sufficient quantities to produce an antiperiodic effect. At 
the same time, continue the syrup. If the disease should 
assume a Typhoid form, Capsicum, in connection with 
small doses of Carbonate of Ammonia, should be given. 
Beef tea, and small quantities of wine, may be adminis- 
tered, to maintain the integrity of the constitution, and 



colic. 89 

the patient's strength. If there should be bronchial 
symptoms, with a persistent cough, twenty or thirty drops 
of the Syrup of Stillingia should be given three or foui 
times a day. 

Where there is Hepatization of any portion of the lungs, 
small doses of Sanguinarin and Iodide of Potassium may 
be given. For further consideration of this subject, the 
reader is referred to Xewton and Calkins on Thoracic 
diseases. 



COLIC, SPASMODIC, OR BILIOUS 
COLIC. 

SYMPTOMS. 

It commences with very acute pain about the region of 
the navel. The patient complains of great thirst, and is 
generally costive. He vomits a hot, bitter, and mostly a 
yellow bile, which at first seems to afford some relief, but 
is quickly followed by the same violent pain as before. As 
the disease advances there is an increased propensity to 
vomit, which becomes almost continual. The natural 
motion of the intestines is so far inverted as to render an 
evacuation almost impossible. If the patient is young and 
plethoric, the pulse will be hard and resisting, the surface 
will be covered with a cold clammy sweat during the 
paroxysm of pain. The vomiting will also prove very 
persistent. 

This disease may be distinguished from inflammation of 
the bowels by pressure upon the abdomen, which in bilious 
colic always affords relief; but, on the contrary, in 
inflammation of the bowels it increases the pain and 
aggravates all the symptoms. 



90 LEAD OLIO. 

CAUSES. 

The causes of this disease may be various, but the effect 
is a spasmodic contraction of the muscles of the bowels. 

TREATMENT. 

U Dioscorine gr. x. 

Pulv. Camphor gr. iij. 

White Sugar . gr. xx. 

Mix, divide into ten powders, and give one every fifteen 
minutes until the patient is relieved. After which, 
R Gelsemin ,. gr. ij. 

Podophyllin gr. ij. 

Capsicum gr. vi. 

White Sugar gr. xx. 

Mix, divide into five powders, and give one every hour, in 
a teaspoonful of Neutralizing Mixture, till it operates as a 
cathartic. 

If the bowels resist the action of the cathartics, they 
should be injected with warm water, and small quantities 
of Lobelia Tea. Also apply a poultice to the bowels made 
of oil meal and mustard ; say ten tablespoonfuls of oil 
meal to one of mustard. The patient should be kept warm 
and in bed. During the convalescence the diet should be 
of easy digestion and nutritious. 



LEAD COLIC. 

SYMPTOMS. 



This disease is preceded by languor, pallor, general 
debility, pain in the .Epigastrium, and a twisting griping 
pain in the region of the umbilicus. 



SCARLATINA, 91 



TREATMENT. 



U Sulphuric Acid gutt. xxx. 

Pure Water " §i. 

Give from ten to twenty drops five or six times a day 
for several days. During the time, a Lobelia emetic, vapor 
baths and mil$ purgatives should be given. 

When the active stage of the disease has passed off, 
vegetable tonics, wine, porter, and a nutritious diet, are all 
that will be required to restore the patient to health. 



SCARLATINA. 

Scarlatina is divided into three varieties, indicating the 
different degrees of severity of the disease, viz : Scarlatina 
Simplex, Scarlatina Anginosa, Scarlatina Maligna. 

SYMPTOMS. 

The mild form of this disease is preceded by coldness 
and shivering, to which succeed febrile heat, thirst, and an 
accelerated pulse. About the fourth day the face swells, 
and irregular patches of a florid red color make their ap- 
pearance on different parts of the body. In the course of 
four or five days, the eruption disappears, and the cuticle 
falls off in branny scales. 

The second variety is marked by previous lassitude, 
dejection of mind, pain in the head, soreness, and pain in 
the muscles of the neck and shoulders, shivering and fever. 
To these succeed nausea, vomiting, difficulty of swallowing, 
a hurried respiration, and frequent sighing. There is a 
quick, weak, and sometimes a hard pulse ; the skin is red, 
hot, and dry ; the tongue is dry, and florid along the 
edges ; and there is great thirst. 

About the third day the redness about the face, neck, 



92 SCARLATINA. 

and chest, becomes more intense, and the glands of the 
lower jaw are painful to the touch. In a few hours the 
redness becomes diffused over the entire body. About the 
fifth day the redness abates, and a brown color succeeds, 
the skin becomes rough, and falls off in large scales. 

In the third variety, in addition to the common symp- 
toms, there is great prostration, the surface has a dark 
livid appearance ; there is nausea and vomiting, a quick 
and feeble pulse, and laborious breathing. There are also 
ulcerations on the tonsils and adjoining parts, covered with 
dark sloughs, and surrounded by a livid base. The efflo- 
rescence appears about the third day, but without relief. 
It assumes a dark purple appearance. Delirium, a debili- 
tating diarrhoea, and hemoiThage, ensue, and in a great 
majority of cases under Allopathic treatment, death closes 
the scene. 

TREATMENT. 

But little treatment is necessary in simple Scarlatina. 
The patient should be kept in bed, and warm. The skin 
should be thoroughly bathed in warm lye water, and the 
surface anointed, after each bath, with sweet oil. A warm 
bread poultice should be applied to the neck, and from one 
to three drops of the Tinct. of Belladonna given five or six 
times a day. 

In the Anginose form a more active treatment is indi- 
cated. A hot onion poultice should be applied to the 
throat, and changed every four or five hours. Every time 
the poultice is changed, the neck should be bathed with a 
liniment composed of the following ingredients : 

R Oil of Stillingia , gss. 

Tinct. of Capsicum gij. 

Oil Origanum gj, 

Mix. ( 

Bathe the entire body, as in the simple form, with lye 
"water, but add to every ounce of the sweet oil one-half 



SCARLATINA. 93 

ounce of pyroligneous acid, and anoint the surface as 
before. Add twenty grains of triturated Belladonna to 
half a tumbler of soft water, and give one teaspoonful every 
half hour. Also, give the following compound : 

R Capsicum gr. xx. 

Trit. Hydrastin gr. xx. 

Mix, divide into ten powders, and give one every three 
hours in a teaspoonful of sweet cream. These medicines 
should be continued until the disease abates. At the same 
time keep the bowels in a soluble condition by the use of 
warm water injections. 

There is always extensive capillary congestion in the 
malignant form, not only in the glands of the throat, but 
through the entire system. To remove this capillary con- 
gestion, and bring about a reaction, is the first indication 
to be fulfilled in this form of the disease. For this purpose 
the following compound may be given : 

R Xanthoxylin gr. xx. 

Capsicum *». gr. x. 

Hydrastin gr. xx. 

Mix, divide into ten powders, and give one every half 
hour. If practicable, put the patient in a warm bath ; 
otherwise, apply hot packs to the bowels, back, and extre- 
mities ; also, apply sinapisms to the feet and calves of the 
legs. If these measures fail to produce the desired effect 
in a few hours, hot rum toddy may be given in connection 
with them in sufficient quantities to produce the wished-for 
result. When the reaction is fully established, the patient 
should be placed upon Belladonna, as in other forms of 
the fever. Also, give the following antiperiodic : 

U Quinine gr. xx. 

Baptism gr. v. 

Hydrastin gr, xxi. 

White Sugar , gr. xxx. 



94 PERTUSSIS. 

Triturate, mix, divide into ten powders, and give one 
every two hours until all are taken. The onion poultice 
should be applied to the neck, as in the other forms of the 
disease ; also, the oil and acid to the surface. The throat 
should be frequently bathed in a strong solution of Hydras- 
tin and Bayberry, and the diet should be highly stimulat- 
ing and nutritious. 



PERTUSSIS, OR HOOPING COUGH. 

The Hooping Cough is usually described as a disease 
of childhood ; occurring but once in the same individual, 
usually at some age before puberty, and propagated by 
specific contagion. It mostly prevails as an epidemic ; 
hence, a large number of individuals are attacked at about 
the same time. The diagnosis of Hooping Cough is, a 
suffocating convulsive cough, returning in regular parox- 
ysms, and terminating in an excretion of thick, glary 
mucus. The cough is marked by a prolonged stridulous 
convulsive inspiration, attended by a peculiar tracheal 
rattle, and followed by short efforts of inspiration in rapid 
succession. The long Hooping inspiration is almost im- 
mediately repeated, and thus the paroxysm continues often 
for some minutes, until there is a discharge of slippery 
mucus, either by expectoration or vomiting, when the 
respiration becomes comparatively easy. 

During the paroxysm, the face becomes much injected 
and red, the eyes suffused, and there is violent spasmodic 
action of all the muscles of the respiratory organs. 

Hooping cough is not unfrequently combined with 
bronchial inflammation, and in these cases, there is more 
or less cough between the paroxysms. 

The latent stage of the disease, is from eight to fifteen 
days. The cause of the spasmodic symptoms, is a closure 
of the glottis. When the disease is unaccompanied by 



ERYSIPELAS. 95 

severe bronchial affections, and is not connected with 
Pneumonia, Trachietis, or inflammation of the brain, it is 
seldom attended with danger. When it is thus compli- 
cated, each disease should be treated separately. 

TREATMENT. 

For the primary disease, take of oil of Skunk Cabbage 
berries, from one to three drops, four or five times a day. 
Or, 

U Pulv. Alum gr. xx. 

Cochineal gr. x, 

Syrup of Stillingia giss. 

Mix, and give one half teaspoonful three or four times a 
day. 

Or, * 

U Triturated Belladonna gr. xxx. 

" Sanguinarin gr. xx. 

" Eupatorin .» gr. xx. 

Mix, divide into fifteen powders, and give one three times 
a day. Once in five or six days, give from ten to fifteen 
grains of Sulphate of Cinchonin, divided into six parts, 
and taken at intervals of three hours. 



ERYSIPELAS — ST. ANTHONY'S FIRE. 

S Y M P T M S . 

Shivering, thirst, pain in the back, limbs, and head, loss 
of strength, restlessness, quick pulse, nausea, and some- 
times vomiting. In the course of a few hours, a red spot 
appears upon some part of the face, which tumefies and 
spreads rapidly. It may confine itself to the skin, or dip 
deep into the adjacent areolar and cellular tissues, pro- 
ducing Phlegmonous Erysipelas. There is general fever, 
a hard and full pulse, and coated tongue. The inflamed 
parts become of a dark purple appearance, terminating in 
large and extensive abscess, or in gangrene and death. 



96 ERYSIPELAS. 

This form of the disease often assumes a periodic cha- 
racter, spreading with great rapidity for a few hours, pro- 
ducing dangerous constitutional disturbance, then subsiding 
for from twelve to twenty -four hours, when it renews its 
attack with more than former violence. 

The prognosis of Erysipelas is always favorable, under 
Eclectic treatment, with good constitutions. 

TREATMENT. 

The first thing to be done in the treatment of this dis- 
ease, is to give a thorough cathartic of Juglandin and 
Menispermin. 

R Juglandin gr. x. 

Menispermin g£ x. 

Hyociamin , gr. j. 

White Sugar... gr. xxx. 

Triturate, mix, divide into ten powders, and give one 
every hour, until it operates as a cathartic. 

At the same time, the patient should take a vapor bath, 
and the inflamed part should be thoroughly covered with 
Collodion. After the operation of the cathartic, the fol- 
lowing compound should be given : 

J£ Cinchonin , gr. xx. 

Quinine gr. x. 

Capsicum gr. x. 

Gelsemin gr. j. 

Mix, divide into eight powders, and give one every three 
hours, until all are taken. After which, give from five to 
ten drops of Muriated Tct. of Iron, every two or three 
hours. The diet should be nutritious, and the surface 
frequently sponged with warm lye water. If there is 
fever, Veratrum or Aconite should be given to control it. 
The inflamed parts should be constantly protected by 
repeated use of the Collodion. 



PLEURITIS. 97 

PLEURITIS.* 

SYMPTOMS. 

Acute sthenic pleuritis usually commences with a chill, 
soon succeeded by an acute lancinating pain in the side, 
cough, short and quick breathing, and fever. 

Each of these will receive particular notice. 

The pain may come on either before, at the same time, 
or a short time after the chill. In character it is severe, 
as if resulting from the thrust of an instrument, and hence 
it is often called a stitch in the side. Usually it is felt 
somewhere in the mammary region ; but sometimes, else- 
where ; sometimes near the lower margin of the chest, in 
which case it is, probably, the result of inflammation of 
that part of the pleura which covers the diaphragm. In 
most cases it is confined to one place ; but it may be dif-^ 
fused over the surface of the chest, when it is sudden, very 
sharp and severe. 

It is so nearly simulated by the nervous pains in hysteria, 
that it may lead to error in diagnosis. By inspiration, 
cough and motion, it is increased. Generally lying on the 
affected side, and pressure over the intercostal spaces, 
aggravate it. There is, a day or two after the occurrence 
of the most severe pain, a greater degree of soreness ex- 
ternally, than when early in the disease the pain is most 
acute. As the effusion increases, the pain decreases in 
consequence of the separation of the inflamed membranes 
by the fluid, and the prevention of friction. It is, in some 
cases, almost entirely wanting, being perceptible only as 
soreness on pressure. 

The cough is usually short and dry, attended with but 
little expectoration of mucus or frothy matter. Sometimes 
a more copious expectoration is present. When the 

* Newton and Calkins. 



98 PLEURITIS. 

pleuritis is complicated with a degree of bronchitis, it is 
occasionally somewhat bloody. Severe pain often attends 
it, to avoid which, the patient tries to suppress the cough, 
and to a certain extent he succeeds by the effort. In some 
cases, however, this is wanting. When such is the fact, 
and there is at the same time no pain, the disease, by some 
authors, is called latent pleurisy. 

The breathing, in most cases, is more or less difficult. 
The pain has the effect of preventing a full, deep inspiration. 
The patient is said to have a catch in his breath. In 
consequence of this, less air is taken into the lung when 
the pleura is affected, and the frequency of respiration is 
therefore increased, inversely, as the quantity of inspired 
air at each inspiration decreases. The dyspnoea, unlike 
the pain, increases as the disease advances. The effused 
fluid filling up the space usually occupied by the lung, 
causes this symptom. 

The function of one lung is more or less suspended, and 
the action of the other is increased beyond its normal 
degree, so that the breathing of the patient becomes pain- 
ful and difficult. This is more particularly the case when 
the effusion is both sudden and copious. When gradual, 
the system accustoms itself to the abnormal condition of 
the respiratory organs. In the latter stage it is most 
severe. 

The decubitus has been considered as a pathognomonic 
sign of the disease. Yet there is much variance among 
observers in respect to this symptom. „ This results from 
the variation of the decubitus in the different stages of 
pleuritis. At first the patient cannot lie upon the affected 
side, on account of the increase of pain which that position 
produces. At a later stage, when the effusion separates 
the inflamed surfaces, the pain resulting from the position 
of the two portions of the pleura becomes less, and some- 
times is entirely wanting. When the decubitus is on the 



PLEURITIS. 99 

sound lung, the weight of the effused fluid, pressing on 
the mediastinum, and forcing this beyond the median line, 
preventing the ingress of air into the sound lung, causes 
pain from dyspnoea. And, consequently, at this period of 
the disease, the decubitus is most free from unpleasant 
sensations on the affected side. 

The fever is usually considerable, and attended with the 
most common phenomena of febrile affections. The pulse 
is quick, sometimes rising to over a hundred beats in a 
minute, hard, full and tense. The skin is dry and hot, 
particularly over the chest, or the seat of the disease. 

The tongue is parched, the urine scanty and high-colored, 
and occasionally there are cerebral symptoms. 

Of the fever there are often daily remissions and exacer- 
bations, the former coming on in the morning, the latter 
in the afternoon or evening. In four or five days it 
moderates considerably. 

TREATMENT. 

In strong and plethoric individuals, where there is a 
marked case of sthenic pleuritis, the stomach should be 
thoroughly evacuated by a Lobelia and Boneset emetic, 
followed by an active cathartic of Jalapin and Cream of 
Tartar. The affected side should be packed with cold 
water, and the patient caused to take from five to ten 
drops of the Tinct. of Yeratrum Yiride every half hour, 
until the symptoms of the disease abate. After which, the 
following compound should be given : 

R Asclepin , gr. xx. 

GelsemiiK gr. ij. 

White Sugar, gr. xxx, 

Triturate, divide into ten powders, and give one every 
three hours. The patient should drink freely of some 
diuretic mucilage, such as marshmallow or flaxseed. 

If the case be one of asthenic pleuritis, the emetic and 



100 PLEURITIS. 

cathartic should be omitted, and hot packs applied to the 
side or sides, and the Tinct. of Aconite given to control 
the inflammatory action, say from one to five drops every 
one or two hours. Also give the following compound : 

U Asclepin . gr. xx. 

Sanguinarin gr. x. 

Quinine , gr. x. 

White Sugar gr. xxx. 

Triturate, mix, divide into ten powders, and give one every 
two or three hours. If the disease is not subdued, the 
following compound may be given : 

U Eupatorin gr. xx. 

Sanguinarin „.. gr. x. 

Apocynin.. ........ gr. x. 

White Sugar.... gr. xxx. 

Triturate, mix, divide into ten powders, and give one 
every three hours. If there should be extensive effusion, 

R Syrup of Marshmallow- §iij. 

Iodide of Potassium gr. xxx. 

Mix, and give one teaspoonful four or five times a day. 
Where there is much debility, beef tea, wine, porter, in 
connection with Iron by Hydrogen, should be freely given. 
The surface should be thoroughly bathed, and the patient 
caused to remain quiet in bed. If expectoration is 
difficult, small doses of Lobelia may be given three or 
four times a day. Where there is a tendency of the 
disease to assume a chronic form, an irritating plaster 
should be placed over the seat of the disease, and allowed 
to remain until a free discharge ensues. The patient's 
strength should be supported by vegetable tonics and 
chalybeates. 



CHRONIC PLEURITIS. 101 

CHRONIC PLEURITIS. 

This disease being so well described by my colleague, 
Prof. Calkins, in his work on thoracic diseases, I shall 
offer no apology for transferring it to these pages. 

"Chronic Pleuritis," says Prof. Calkins, " yaries 
greatly, both in seyerity and duration. It may be acute, 
in respect to the degree of suffering and the rapidity of 
its progress ; it may be latent in its character, and slow 
in the progress of the successive changes attending and 
consequent upon it. Between these extremes, the inter- 
mediate grades of morbid action are almost innumerable. 
The term chronic, then, when applied to pleuritis, seems 
to be more of a conyentional term than in respect to other 
diseases. In pleuritis, the transition of the acute to the 
chronic state is so indefinite, and the symptoms of the 
recent disease sometimes haye so little of an acute cha- 
racter, while that of a long duration occasionally manifests 
so much greater an intensity of irritation, that the terms, 
acute and chronic, would seem to be less applicable to 
pleuritis than to other diseases. This difficulty arises 
from the anatomical relations of the pleura. Being a shut 
sac, its acute inflammation is liable to be made chronic by 
the retention of inflammatory products ; and the chronic 
is liable to be changed into the acute by the irritation of 
effused fluids 

"But, notwithstanding these difficulties, there seems 
to be no impropriety in ascribing to the disease, when 
highly inflammatory, and until the inflammatory symptoms 
seem to arrive at an acme, the term acute. If, after that 
period, lingering fever continues, evidently excited by the 
products of previous inflammatory action, then the term 
chronic may, with as much propriety, be applied to the 
disease after, as acute to the disease before the acme. In 
some cases, however, such an acme seems never to exist ; 
9 * 



102 CHRONIC PLEURITIS. 

and to these the name sub-acute may with propriety be 
applied. n 

Pathology. — The anatomical appearances caused by 
chronic pleuritis, are very similar to the acute form of the 
disease. Of course, the influence of time would tend to 
produce certain modifications. 

In general, we find the membranes thicker, often com- 
posed of several adherent layers, the earliest deposits 
being harder than those subsequently formed. The cha- 
racter of the liquid, too, is subject to various changes in 
the onward progress of the disease. It is less limpid, 
more prone to become turbid with flocculi of a fibrinous 
character. In some cases, it even appears in consistence 
like jelly. The quantity is greater, and consequently, the 
displacement of adjacent viscera is much more apparent. 
Here and there, adhesions are often formed between the 
pleura and lungs, which, in some cases, enclose little sacs 
of fluid. 

Under the best treatment, the disease, when uncompli- 
cated, will generally advance to a favorable termination. 

But it often is the case, that the morbid products cannot 
be absorbed, and, consequently, they remain and pass 
through a series of pathological changes, sometimes ending 
in gangren-e. Cartilaginous laminae, bony plates, abscesses, 
tubercles, and hemorrhagic effusions, are among the succes- 
sive steps in the progress of chronic pleuritis. 

" Sometimes/' says Dr. Wood, "the walls of the chest 
are forced inward contrary to their elasticity, so that, when 
si puncture is made from without, the air rushes in to sup- 
ply the vacuity produced by their resilience. In some 
cases, secretion goes on as rapidly as absorption, and the 
liquid accumulation remains for a great length of time. 
This is especially the case in empyema, or collection of pus 
in the cavity of the pleura. Sometimes the pus makes its 
way into the substance of the lung, and a fistulous commu- 



CHRONIC PLEURITIS. 103 

nicatioE is formed between the bronchi and the pleural 
.cavity through which pus is discharged and air admitted. 

" In other instances the liquid takes an external direction, 
and by means of ulceration escapes into the cellular tissue 
without the chest, and, travelling occasionally for a consi- 
derable distance, produces sub-cutaneous abscesses in va- 
rious parts of the chest, which ultimately open, unless life 
is previously worn out. In thus travelling, the pus has 
been known to occasion caries of the ribs and vertebra?. 
Sometimes the purulent collection is found to be connected 
with a tuberculous vomica." 

It is sometimes difficult to determine the causes which 
change ordinary acute pleuritis into the chronic form. 
Evidently, in many cases, too much depletion, the too fre- 
quent use of mercury, and other articles making up the 
antiphlogistic regimen, tend to the production of chronic 
pleuritis. Often, when a case seems to be cured by such 
means, the impoverished state of the blood, caused by the 
use of the lancet, thus rendering the system more liable to 
be affected by low grades of inflammation, developes a new 
and unwelcome train of symptoms, admonishing the physi- 
cian that the supposed cure was, after all, delusive. 

Dr. Gallup, defining chronic rheumatism, says that it is 
acute rheumatism half cured. So, it may be said with 
equal propriety, that chronic pleuritis is the acute variety 
half cured. 

Diagnosis. — The general inflammatory symptoms of 
acute pleuritis may gradually disappear ; but, unless the 
morbid products of the diseased action are removed from 
the pleural sac, the fever will recur, and change its type, 
now very closely resembling hectic, now becoming identical 
with it. This recurring fever is one of the most trouble- 
some and alarming symptoms of chronic pleuritis ; for in 
other respects the patient does not suffer in proportion to 
the extent or duration of the effusion. 



104 CHRONIC PL EURITIS. 

Dr. Gerhard observes: "I once saw a patient who had 
performed the full duties of a sailor, going aloft with an 
enormous pleuritic effusion. When he returned from sea, 
it amounted to two or three gallons. This is an excep- 
tional case ; but it is very common to find patients who 
can perform many laborious occupations without much in- 
convenience. This is generally the case if the dyspnoea is 
not severe ; and we find that some patients complain of 
little difficulty of breathing, with an extent of pectoral dis- 
ease, which will give rise to great distress in other indi- 
viduals. The symptoms which so frequently characterize 
chronic organic diseases, are extremely variable in this va- 
riety of pleurisy. These are emaciation, loss of the firm- 
ness of the muscles, harshness and dryness of the skin, and 
slight oedema of the legs. Sometimes they are nearly as 
well marked as in tuberculous disease of the lungs; — in 
other cases they are very slight ; hence they constitute a 
diagnostic sign of the disease ; and if we find them well 
characterized, we will do right to regard the case as one 
probably complicated with tubercles. If our impression 
be erroneous, we will soon rectify it as the symptoms will 
gradually become more decided in the latter case, and 
slowly disappear if the pleurisy be followed by recovery. " 

The diagnosis of chronic pleuritis, without the aid of 
the physical signs, is often very difficult.* Its general 
symptoms simulate those of phthisis. But the physical 
signs are far more reliable. When these are present, there 
is no difficulty in ascertaining the true character of the dis- 
ease. If it is complicated with tuberculous deposition, the 
case should be regarded with much anxiety : for the diag- 
nosis then becomes much more obscure, and the prognosis 
more " unfavorable. " 

* See Empyema. 



CHRONIC PLETJRITIS. 105 



PROGNOSIS. 



The prognosis of this disease depends much upon the 
extent of the effusion, the condition of the constitution, and 
the tendency to hereditary disease. Also, upon the skill 
with which the disease is treated. If the integrity of the 
constitution is not too much impaired, and there is not a 
marked tuberculous tendency, under a judicious treatment 
our prognosis will be favorable. 

TREATMENT. 

The treatment of this disease depends upon the constitu- 
tion of the patient. If there is still an inflammatory pro- 
cess going on, Aconite, in connection with Veratrum and 
Gelsemin, should be used until it is controlled. As for 
instance, if the skin is hot and dry, the pulse quick, the 
urine scanty, with more or less dyspnoea, and alternate 
pyrexia, the following compound may be given : 

R Gelsemin gr. j. 

Quinine ♦ gr. xx. 

Asclepin , gr. x 

White Sugar gr. xxx. 

Mix, triturate, divide into ten powders, and give one every 
two or three hours until all are taken. 

If the symptoms should not subside under this prescrip- 
tion, the irritating plaster should be applied over the 
entire surface of the affected side, and a thorough spirit- 
sweat be given ; after which, the following mixture : 

R Syrup of Tolu... giij. 

" Sanguinarin gij. 

" Iodide of Iron gij. 

Mix, dose one teaspoonful every three hours. 

If there are febrile symptoms, from one to three drops 
of the Tct. of Aconite should be given every three hours, 
in connection with the above mixture. 



10G CHRONIC PLEURITTS. 

The diet should be nutritious and stimulating, and if 
there is much debility, a small quantity of Porter or Scotch 
Ale should be taken four or five times a day. If there is 
much effusion, an attempt should be made to produce ab- 
sorption by the following mixture : 

R Syrup of Iodide of Potassium !|j. 

" Apocynin gij. 

" Stillingia giij. 

Mix, dose one teaspoonful three or four times a day. At 
the same time drink freely three limes a day of a tea made 
of equal parts of Eupatorium, Purpureum and Pipsissewa. 
Tf the strength of the patient will bear it, one eighth of a 
grain of Phytolaccin and five grains of Cream of Tartar 
should be given. 

The irritating plaster should not be removed until a free 
discharge ensues, which should be maintained by the 
occasional use of the vegetable caustic, and a constant 
application of slippery elm poultice. If the absorbents 
should prove too debilitating to the patient, they should 
be discontinued for a few days, and the following tonic be 
given : 

U Hydrastin gr. x. 

Phosphate of Iron gr. xx. 

Prunin gr. x. 

White Sugar gr. xxx. 

Mix, triturate, and divide into ten powders, and give one 
every three hours. 

If there are periodical symptoms in connection with 
debility, and the above prescription should fail to give 
relief, five drops of the muriated Tct. of Iron, and two grains 
of Quinine, should be given four times a day. Also a 
liberal supply of beef tea, prepared as directed in treat- 
ment of Typhoid Fever. After recruiting the patient's 
strength for some days, the diuretics and absorbents should 
again be resumed, and persisted in for the purpose of pro- 



EMPYEMA. 10? 

during absorption of the effused fluid. If the above treat- 
ment should prove unsuccessful, and the Empyema likely 
to prove disastrous to the patient, the operation of 
Paracentesis Thoracis should be performed as directed 
under the head of Empyema." 



EMPYEMA 

Is a collection of fluid in some part of the body, par- 
ticularly in that of the pleura. It -consists mostly of a 
purulent, sero-purulent or serous fluid, within the cavity of 
the pleura, and is dependent upon chronic pleurisy. When 
inflammation attacks a serous or diaphanous membrane, it 
loses its transparency, becoming dull, and in some instances 
dry. These changes may be observed not only in the 
Pleura, Pericardium and Peritoneum, but in the arachnoid 
membrane, in which it is distinct when other traces of 
inflammation cannot be recognized. At the same time, 
red vessels appear in isolated spots over a considerable 
extent. They are arborescent, and consist of minute red 
lines radiating from star-like points. These vessels, though 
placed in the substance of the membrane, gradually ap- 
proach the surface as the process advances. They are not 
newly developed, but are the colorless capillaries of the 
sound part, injected with red blood. After existing for a 
longer or shorter time, these changes are succeeded by 
others, which are regarded as their effects. The first and 
most important of these is, the formation of a new fluid at 
the free and inadherent surface of the membrane. 

The nature of the fluid varies according to the stage of 
the inflammation. In the commencement of the inflamma- 
tion, the capillaries begin to deposit a semi-transparent 
fluid, in small quantities, w T hich becomes more abundant as 
the disease advances. It is straw-colored, of a hornoge- 



108 EMPYEMA. 

neous character, and, as it is effused, undergoes sponta- 
neous coagulation. This consists in part of the fluid 
attaining a solid form like a jelly in layers of variable 
thickness, with a honey-comb surface, and thready fila- 
ments coalescing and quite consistent. A small quantity 
of a thin fluid is found in the interstices of these filaments, 
oozing from the surface of the coagulated part, and lodging 
in the most dependent part of the cavity. This process 
may continue until a large amount of fluid is accumulated, 
or the entire product of the inflamed surface may be defi- 
cient in albumen, producing an extensive accumulation of 
sero-purulent fluid. 

Baillie and other observers state "that this fluid has 
been supposed to be derived immediately from the blood ; 
but that this is not correct, as it is the serous or watery 
portion of the morbid exudations, from the surface and 
interstices of which it may be seen trickling. 

The red or brown tint is derived from the blood issuing 
from the newly-formed capillaries. Shreds of lymph are 
found floating in it when the accumulation occurs in the 
pleural cavity. The sero-purulent is often connected with 
albuminous fluid, from w T hich it is separated during the 
process of coagulation. It consists mostly of serous fluid, 
with minute granules of albuminous matter, which precipi- 
tate to the bottom, leaving a chalk-like liquid, which con- 
stitutes the majority of the effused fluid in the cavity. In 
this fluid may be seen small particles of lymph afloat. The 
puriform fluid of serous membranes consists of serous fluid 
w T ith small granules of opaque matter, not coagulable, and 
is considered as an abortive effort to produce albuminous 
exudation. The puriform deposit mostly occurs in the 
peritoneum. It is a white or cream-colored opaque fluid. 
It occurs mostly in chronic pleurisy and peritonitis. It has 
been supposed that genuine purulent matter was not formed 
unless there had been previous ulceration of the part. But 



EMPYEMA. 109 

the researches of Baillie, Black, Hunter, and Millin, have 
amply shown that purulent fluid may either be secreted by 
the inflamed membrane, or from the organized layers of 
lymph, or from both. In the first, the fluid is secreted 
directly from the capillaries of the inflamed membrane. In 
the second, it is derived from the organized false mem- 
branes which take on the suppurative action. In the third, 
both sets of vessels are concerned. 

S Y M P T M S . 

The patient either lies on his back diagonally, or on the 
diseased side with the head slightly bent forward. The 
voice is weak, and there is a persistent cough, with more 
or less expectoration of mucus or muco-purulent matter. 
The face is buffy, and semi-transparent ; the lips tumid and 
livid. The pulse is habitually quick and small, and febrile 
attacks are frequent, and often connected with chills. In 
recent empyema, the diagnosis may be confounded with that 
of pneumonic solidification. But in empyema, vocal fre- 
mitus disappears. In hepatization of the lung, it is main- 
tained, and frequently above the average of health. 

In empyema there is no crepitant rhonchus, nor is there 
true tubular sniffling, metallic respiration ; vocal resonance 
is well or weakly bronchophonic. There is dulness on per- 
cussion over the entire pleural sac, and not unfrequently 
effusion becomes so extensive as to force the lung towards 
the mediastinum and spine, compressing it in so small a 
bulk that it appears to be destroyed. Its vessels are 
crushed together ; its bronchial tubes and vessels closed, 
and the whole organ is rendered unfit for respiration. 
Unless much care is taken in diagnosis, this condition will 
be mistaken for atrophy of the lungs. In other cases the 
heart and mediastinum are carried over to the right side, 
and the heart will be found beating on the right side of the 
sternum between the third and fourth ribs. 
10 



110 EMPYEMA. 

A case of this kind occurred in my practice, where the 
effusion, following latent pleuritis, was so extensive that it 
not only carried the lung forward and backward towards 
the mediastinum, and against the spine, compressing it so 
completely, as to prevent the ingress of air ; but, the 
heart and mediastinum were carried forward, and beneath 
the sternum, so as to encroach materially upon the right 
lung. In this case, the symptoms at first were those of 
latent pleuritis, followed by a persistent cough, with 
expectoration of muco-purulent fluid, great dyspnoea, and 
inability to lie on the affected side. There was great dul- 
ness on percussion, which extended an inch over the right 
of the sternum. 

The only physical signs which were diagnostic of the 
disease, were the absence of respiratory murmur on the left 
side, and the deviation of the area of dulness upon percus- 
sion ; on changing the position of the patient, the dysp- 
noea and the increased diameter of the left half of the 
chest, which was three and one-half inches greater than 
the right. In this case, absorbents, diuretics, and tonics, 
only gave temporary relief. And in the course of two 
and one half years, an opening made its appearance in 
the base of the pleura and diaphragm, where it had previ- 
ously become attached, and the fluid made its escape into 
the cavity of the abdomen, producing peritonitis and 
death. The patient refused to submit to the operation of 
Paracentesis. Dr. Hughes reports a case of thoracic dis- 
ease, where the patient became much debilitated, with 
quick pulse, dyspnoea, and every physical sign of effusion 
into the right pleura. There was no bulging of the inter- 
costal space ; but a fiat fluctuating tumor was observed, 
which dilated upon coughing. A small trochar was intro- 
duced, and twenty-four ounces of turbid serum were 
drawn off. Iodide of Potassium and Sarsaparilla were 
taken, which afforded partial relief, — yet, he states that he 



EMPYEMA. Ill 

operated again, .in two weeks, and drew off thirty-six 
ounces more. Xo inconvenience followed, and the patient 
appeared much improved. Some two months afterward, 
the tapping was again repeated, and twelve ounces of 
fluid were drawn off. In two months more his health ap- 
peared good ; but there seeming to be an increase of fluid, 
tapping was again performed, and thirty-six ounces of 
fluid evacuated. He was tapped again on the eighteenth 
and twenty-sixth of November successively, which was 
also again performed on the twenty-first of December. 
Finding that repetition of the operation must still be con- 
tinued, the patient learned to perform it himself, and 
actually did so twice. The prognosis was subsequently 
favorable, and after fifteen tappings his restoration was 
complete. 

TREATMENT. 

The first efforts of the physician should be to produce 
absorption, which can be accomplished, in most cases, 
where the walls of the sac are in a normal condition. But, 
unfortunately, in many instances the albuminous exudation 
forms a complete false membrane to the internal walls of 
the sac, which entirely precludes the action of the absorb- 
ents upon the effused fluid. In this event but little can 
be expected from the use of remedies, until the fluid is 
evacuated by means of the trochar. 

The operation of Paracentesis Thoracis is performed in 
this manner. The patient should be propped up in bed, 
and inclined a little to the sound side, so as to separate the 
ribs, as much as possible, on the diseased side. The skin 
is to be divided to the extent of one and a half inches, in 
a direction parallel with the superior edge of the lower rib, 
on the intercostal space that is selected for the puncture. 
After dividing the superficial fascia, and any portion of a 
muscle of the chest that may intervene, as well as the 
external and internal intercostal muscles, the pleura will 



112 EMPYEMA. 

be seen to bulge into the wound. After being distinctly 
felt by the finger, so as to establish the fact that only fluid 
is behind it, a trochar, armed with a canula, should be 
introduced through the sac ; the trochar should be with- 
drawn, and the canula allowed to remain until the fluid is 
discharged. Or the pleura may be punctured by means of 
a sharp-pointed bistoury. On making an incision through 
the integument, the skin should be drawn up from an inch 
to an inch and a half above the intercostal space intended 
for the internal opening, so that after the evacuation of 
fluid, the integument, by passing down over the internal 
wound, may exclude the air from the pleural cavity, which 
is one of the most essential conditions to be observed in 
this operation. 

If there is a probability that the fluid may be absorbed, 
an attempt should be made, by the use of the following : 
U Corydalin gr. x. 

Phytolaccin , gr. ij. 

Iodide of Potassium gr. xxx. 

Syrup of Marshmallow giij. 

Triturate, and mix well together ; give from one half to 
one dram three times a day. 

At the same time apply the irritating plaster to the 
affected side, until a free discharge ensues. 

The strength of the patient should be maintained by the 
use of porter, wine, beef tea, and such articles of food as 
are easy of digestion. When the above remedy has been 
used for two or three weeks, a change may be made to the 
following : 

U Quinine gr. xx. 

Digitalin gr. ij. 

Bitartrate of Potassa gij. 

Syrup of Stillingia and Syrup of Iodide 

of Iron., aa gij. 

Mix, and give one half teaspoonful three times a day. 



PHTHISIS. 113 

The skin should be thoroughly bathed in lye water two or 
three times a week, and every effort should be made to 
preserve the patient's strength. 

If, after the above treatment, and such other remedies 
as seem to be indicated, the patient is not materially 
relieved, tapping should be resorted to at once. In per- 
forming this operation, much care is required to prevent 
the ingress of air into the cavity of the chest. Other- 
wise empyema would be removed only by substituting 
emphysema. After the operation, a general diuretic, altera- 
tive, and tonic treatment should be pursued, for the pur- 
pose of preventing a re-accumulation of the fluid. If 
empyema is connected with organic disease of the lungs, 
or general tuberculosis, much relief may be obtained 
from the operation of Paracentesis. Although it may not 
effect a cure, still it will very materially assist your 
constitutional treatment. 



PHTHISIS.* 

" The essential character of pulmonary consumption 
consists in the deposit of tubercles in the tissues of the 
lungs. This deposit may begin with local mischief, or 
may evidently be the sequel of constitutional disorder. 
In both varieties the general disease is present, although 
it may exist in a latent form. Of this the formation of 
tuberculous matter is a proof. It is evident, however, 
that the presence of tubercles does not alone constitute 
the disease. One step back, along the chain of causation, 
is a morbid condition, of which tubercles are but the 
effect. This morbid condition, whatever is its nature, may 
exist a long time before the formation of tubercle begins. 

* Newton and Calkins. 
10* 



114 PHTHISIS. 

That a change takes place in the blood, which causes or 
precedes the deposit and development of tubercles, is well 
established. The corpuscles are diminished, and the 
albumen increased in quantity. The fibrin is below, rather 
than above the normal amount, and, it may be inferred, 
that it is also defective in its nature. Eisner, and some 
other analysts, have found the fatty principles diminished. 

Dr. Fricke's analyses indicate an increase above the 
standard of health, in the lime, and a decrease in the 
phosphates ; while l'Heritier states, that in scrofula the 
earthy salts are diminished. Hence, the blood may be 
stated generally to be degraded in quality, and endowed 
with a low degree of vitality. Whether these be the real 
changes in the blood is not certainly determined. Physio- 
logists and pathologists are not fully agreed as to the 
nature of all the changes which the blood undergoes in 
the scrofulous diathesis. Andral showed that in phthisis 
pulmonalis, the fibrin was augmented. The probability 
is, that this increase of fibrin is most frequent, when inter- 
current pneumonitis is associated with tubercular disease. 
To attain to accuracy in this matter is very difficult, on 
account of the variable state of the blood, arising from 
exercise, diet, time of the day, and other changing circum- 
stances. 

The conclusions to which we may logically come, are 
the following: 1. That from the earliest invasion, the 
sum of the vital force is either below the standard of 
health, or it is relatively low as respects the structure and 
organization of the individual. 2. That this diminution 
in the sum of the vital force, is dependent on the imperfect 
blastema of the diseased blood, causing perversion of the 
tissues. 3. That as tuberculosis advances, the sum of the 
vital force for the whole system, continues to diminish. 
4. That the nutritive powers of the blood, .as respects the* 
nervous tissue, frequently remains undiminished ; this 



PHTHISIS. 115 

tissue not requiring for its nutrition, compound principles 
identical with it to be introduced into the blood with the 
food, and having a nutrition peculiar to itself, differing 
from that of the cellular and muscular structures. The 
fatal disease tuberculosis may be traced to a primary error 
or defect in the blood-making process. Vitiated air, or 
air stagnating or insufficiently renewed within the chest ; 
and probably other anti-hygienic influences, as a vitiated 
or defective diet, acting singly, coetaneously, or as re- 
spects each other, ancillary, produces slowly under ordi- 
nary circumstances, but occasionally with great rapidity, 
some unknown change in a portion of the proteiniform 
principle of recently formed liquor sanguinis ; this change 
may consist in hyper-oxydation ; but whether so or not, 
it deteriorates its properties, rendering it, more or less, 
altogether unsuitable as a material for organization. 

At the same time, the oily principle of nutrition circu- 
lating with a diminished number of real corpuscles, is in 
part converted into a fatty substance of a lower degree of 
oxydation. These modified proteiniform and oleaginous 
principles are exuded in the blastema, and are either em- 
ployed in the assimilating -processes, deranging the nutri- 
tion of the organic structures, and giving the tuberculous 
or scrofulous character to various pathological processes ; 
or, in the more advanced stages of the morbid process, 
they are deposited in particular tissues, and accumulate 
generally in the form of tubercle, but sometimes both as 
tubercle and morbid fat, substances for the most part inca- 
pable of organization. 

In the present state of pathological science, confining 
ourselves to its legitimate object, the study of phenomena, 
apart from any metaphysical views of final causes relative 
to the pqmers of nature, this appears to be the most accu- 
rate definition that can be given of the most essential na- 
ture of tuberculosis. — (Dr. Ancell.) 



116 PHTHISIS. 

But in what manner does tne deposit take place ? We 
possess sufficient evidence that it is derived from the blood ; 
that it transudes from the capillary vessels of the part in 
which we find it; and that after being deposited, it is liable 
to undergo certain further changes. On the examination 
of incipient tubercular deposit, we may always note that 
there is congestion in the tissues immediately surrounding 
it. In the pia mater of the sylvian fissure, we see an in- 
creased redness, in which a few vessels are more promi- 
nent than usual ; in the pulmonary parenchyma we may 
especially, by the use of the microscope, discover the en- 
gorgement of the interlobular capillaries investing the air- 
vesicle into which the tubercle is being secreted. In the 
mucous membrane of the intestines we see the exquisite 
arborescent arrangement of the congested vessels, tending 
from the mesenteric attachment to the point where we 
observe the deposit, shining through the mucous surface 
from the submucous tissue, where it has collected. The 
first elimination of the morbid products acts like a mag- 
netic point of attraction, and generally serves as a centre 
around which the deposit progressively enlarges by eccen- 
tric deposition. 

Tubercles exist in various forms ; in fine points, grey 
and yellow granulations, miliary tubercles, and grey or 
yellow tubercular masses, softened and cretaceous. Each 
of these modifications requires a more particular notice. 

1. Pulmonary Granulations — Grey Granulations — 
Miliary Tubercles. — These various names have been used 
by authors to describe round, small, translucent, shining, 
homogeneous bodies, often not larger than a millet-seed, 
but varying from this to the size of a pea, which appears 
to be the primitive state of tubercles. Usually they are 
of a greyish, but often they are of a reddish or of a brown- 
ish color, and in some cases they are nearly colorless. 
Sometimes they are isolated, sometimes clustered in small 



PHTHISIS. lit 

bunches, or in aggregate masses. In the latter state they 
are most often found in the upper portion of the lung. 
But in the isolated form they are scattered sometimes 
thickly through the whole or greater portion of the pulmo- 
nary tissue ; not unfrequently they are found situated be- 
neath the pleura, producing an irregularity perceptible to 
the touch. This is more often the case in children than 
adults. 

2. Grey Tubercular InfittraHoh. — Laennec defines this 
as the same kind of matter which forms the granules above 
described, deposited in the cellular tissue of the lungs in 
irregular masses, sometimes one, two, or even three inches 
in cubic dimensions without definite boundaries, or limited 
only by the extent of the lobules. It is hard, homogeneous, 
translucent, and of a greyish color, sometimes darkened by 
the black matter of the lungs, portions of which become 
enveloped in the masses as they are formed. In some 
cases no traces of pulmonary tissue can be detected in the 
masses : in others they present remains of blood-vessels, 
bronchial tubes, and cellular membrane ; and occasionally 
they are partially penetrated by the air in respiration. 

3. Crude Tubercle and Yellow Tuberculous Infiltra- 
tion. — The grey translucent matter constituting the first 
two deposits above noticed, appears to undergo a gradual 
conversion into what has usually been considered the pro- 
per tuberculous substance. In the miliary granulations, 
the transformation commences in a small yellowish, white 
spot, which most commonly appears at or near the centre, 
and gradually enlarges until the whole granule assumes 
that character. 

In this altered state, the little bodies are now called 
crude tubercles. In the aggregated granules, the change 
commences at several points, each probably answering to a 
distinct granule, and considerable masses of yellow opaque 



118 PHTHISIS. 

matter result from the extension and ultimate coalescence 
of these central spots. 

The same transformation takes place in the infiltrated 
translucent matter, beginning in like manner with isolated 
opaque spots, and spreading until it involves the whole 
deposit, which, when thus altered, receives the name of 
yellow tuberculous infiltration. This may be distinguished 
from the crude tubercle by an irregular and angular, in- 
stead of roundish form, and by a less regular line of 
division between it and the pulmonary tissue. There is no 
doubt that both the crude tubercle and yellow infiltration 
are often originally deposited in this state, without the 
preliminary formation of the translucent matter. 

The next important change in tubercle is that of soften- 
ing. This, in many authors, is said to begin in the centre, 
and to gradually advance to the circumference. Concern- 
ing the truth of this, there is, however, some doubt. The 
reasons as given by Mr. Carswell upon which such a doubt 
is based, are the following: — Tubercular matter, accord- 
ing to his theory L is contained in the air-cells and bronchi. 
If, therefore, this morbid product is confined to the surface 
of either,, or has accumulated to such a degree as to leave 
only a limited central portion of their cavities unoccupied, 
it is obvious that when they are divided transversely, the 
following appearances will be observed : — 1. A bronchial 
tube will resemble a tubercle having a central depression, 
or soft central point, in consequence of the centre of the 
bronchus not being, or never having been occupied by the 
tuberculous matter, and of its containing at the same time 
a small quantity of mucus or other secreted fluids : — 2. The 
air-cells will exhibit a number of similar appearances, or 
rings of tuberculous matter joined together, and containing 
in their centres a quantity of the same kind of fluids. 
"When the bronchi or air-cells are completely filled with 
tuberculous matter, no such appearances as those we have 



PHTHISIS. 119 

just described are observed, and hence the reason why 
tubercle, in such circumstances, has been said to be still in 
a state of crudity, or in that state which is believed to 
precede the softening process. 

As the softening process advances, the whole tubercle 
becomes converted into a soft, pultaceous, yellowish mass, 
in appearance resembling pus. The infiltrated mass, like- 
wise, undergoes a similar change. Sometimes the entire 
tuberculous deposit seems throughout its whole mass, to 
become suddenly softened, and, in this manner, large por- 
tions of the lung are quickly destroyed. The pressure of 
the growing tubercle upon the circumjacent lung, at first 
makes it less vascular ; but reaction at length takes place, 
inflammation succeeds, and congestion, ulceration and 
suppuration follow. In some cases the tubercular disease 
passes through its various stages without giving rise to 
marked inflammation. In the majority of cases, however, 
the bronchi, air-cells and cellular tissue, are more or less 
affected by the inflammatory process. The succeeding 
ulceration gives rise to the formation of cavities. Fre- 
quently one large vomica is made up of several smaller 
ones, which, in the parietes of the large cavity, make 
excavations of irregular shape, now winding and now 
crossed by bands of tissue. The size of the cavity varies 
from that of a pea to that of an orange. Its contents 
consist of a mixture of pus and bloody matter, and por- 
tions of pulmonary tissue. Sometimes they are inodorous, 
sometimes fetid. In children the vomica are less common 
than in adults. As the disease advances, a false mem- 
brane begins to form around the decaying tubercle, at first 
thin and delicate, and in appearance resembling mucoua 
membrane. Large abscesses are sometimes seen, between 
which and the bronchi there is no communication. 

Cicatrization of Tuberculous Cavities. — That this it 
not a very rare occurrence, Laennec proved in his early 



120 PHTHISIS. 

researches into the termination of tuberculous disease. 
Indeed, from this we learn that phthisis sometimes termi- 
nates favorably. This happens when the deposit is limited 
in extent. 

But, sometimes at the apex of the lung, we find an old 
adhesion, sometimes a crust of fibro-cartilaginous deposit, 
or even a fibrous band passing from the lung to the ribs. 
Adjacent to this pathological change, the lung is puckered 
and drawn inward. To the touch, it feels firm and con- 
solidated ; to the eye, it appears dark, from an abundant 
deposit of black pigment. On making an incision, we 
find a cavity lined by grey fibrous membrane, semi-trans- 
parent, or thick, whitish, and fibro-cartilaginous, or soft 
and pliable, like the mucous membrane. 

[In the winter of 1855, my colleague, Prof. Hollem- 
back, and myself, made a post-mortem examination of a 
female, who had been laboring under phthisis for the last 
twelve years. In her case the right lung had been entirely 
destroyed, save a very small portion, just below bifurca- 
tion of the bronchi, which was completely injected with 
tuberculous matter. This portion was about the size of a 
hen's egg 7 and completely impervious to air. A fibrous 
band passed from this bunch to the lower portion of the 
pulmonary cavity, and was attached to the pleura costalis. 
The cavity was filled with sero-purulent fluid; but the 
woman had enjoyed a respite from the urgent symptoms 
of the disease, save periodical attacks of dyspnoea, in one 
of which she died. — The Author. ] 

Adhesions are almost always present in phthisis. In 
112 cases examined by Louis, there was only one in which 
no adhesion was found. To some extent, their location 
corresponds to that of tubercles. In rare cases, the entire 
surface of the lung is bound down to the costal pleura, 
and to that of the diaphragm. These have the effect to 
prevent pneumothorax. The trachea and bronchial tubes 



PHTHISIS. 121 

often are the seat of extensive lesion. Those are most 
often affected which form a way of exit to vomica. Their 
posterior, more often than their anterior, internal surfaces 
are affected. The larynx and epiglottis, are sometimes 
the location of tuberculous disease. Among other lesions 
attending phthisis, are partial emphysema- of the lung, 
dilatation of the bronchi, and enlargement of the bronchial 
glands. This latter effect is most common in children. 

Appearances in oilier parts of the body. — The origin 
of tubercles being in the blood, their distribution through- 
out the entire system is a necessary result. But according 
to Louis, this general law is established, that when tuber- 
culous deposit exists in other organs, it always exists in 
the lungs. The converse of this, is far from being true ; 
and the law itself is occasionally subject to exceptions, 
the occurrence of which is most frequent in children. 
Without the lungs, the tuberculous depositions are most 
often composed of the yellow opaque tubercle. Grey 
granulations or miliary tubercles, have also been observed 
in various parts of the body. From some form of tu- 
bercle, scarcely an organ of the body is wholly exempt. 
They are found in the liver, intestines, mesentery, prostate 
gland, testicles, heart, bladder, uterus, spleen, and kid- 
neys, and in the membranes and substances of the brain. 
It was the conclusion of Louis, that, of all the cases of 
tubercles, occurring in persons over the age of fifteen 
years, one-third had them in the small intestines, one fourth 
in the mesenteric glands, one-ninth in the large intestines, 
one-tenth in the cervical glands, one-twelfth in the lumbar 
glands, and one-fourteenth in the spleen. The stomach 
becomes larger than natural, more thin, and is subject to 
chronic inflammation of its mucous surface. The glands 
of Peyer — those near the ccecum — become the seat of 
tubercles. The mucous glands of the small- intestines, 
sometimes ulcerate, causing perforation, and the admission 
11 



122 PHTHISIS. 

of the fecal secretions into the cavities of the peritoneum. 
A similar diseased state of the large intestines sometimes 
occurs. The mesenteric glands are very much enlarged. 
In the brain, tubercular deposition gives rise to hydroce- 
phalus. 

GENERAL SYMPTOMS AND COURSE OF PHTHISIS. 

Since the discovery of the physical signs by Laennec, 
the tendency of some minds has been to disregard the 
general symptoms in the formation of a diagnosis. Among 
such, an unnecessary delay is often caused in the applica- 
tion of remedial agents ; for the general symptoms very 
frequently are the first indications of approaching disease. 
A diagnosis should not then be wholly dependent upon 
the physical signs in the first stage ; for these are seldom 
manifest, until the disease has so far progressed as to 
make a prognosis unfavorable. Certain general symptoms 
are grouped together, and said to be indicative of the 
scrofulous diathesis, or tuberculous cachexia. What 
this condition of the system is, or what it* influence, in 
the development of phthisis, it may be difficult to accu- 
rately ascertain ; and yet the description of some of its 
more important symptoms, may be of utility in detecting 
that first pathological change in which phthisis begins. 

Among the more important symptoms are, a pale, pasty 
appearance of the countenance, large upper lip aud alce- 
nasi. In persons of dark complexion, the skin is sallow ; 
in those of fair complexion it is unnaturally white, resem- 
bling blanched wax rather than a healthy countenance. 
The veins are large and conspicuous, the pupils of the eyes 
are large, eyelashes long, with a fair, florid complexion. 
In persons of a bilious temperament the skin is coarse, its 
color dingy. The form of the body is often destitute of 
symmetry. The trunk is small, the head large, abdomen 
tumid, limbs unshapely, the growth of the body is irregular, 



PHTHISIS. 123 

the functions of nutrition are feeble and deranged. The 
intellect is often very active ; there is great sensibility to 
impressions and acuteness of mind. 

Stages. — For convenience in description, phthisis has 
been divided into three stages. Between these no line of 
demarkation is accurately drawn. The first stage begins 
with the onset of the disease, and ends when the softening 
of the tubercle has commenced. 

General Symptoms. — The pulse is accelerated, espe- 
cially after eating, towards evening, or by slight exercise. 
A burning sensation is felt in the palms of the hands and 
soles of the feet. Towards evening a slight chilliness 
comes on ; towards morning, perspiration supervenes. 
The febrile paroxysm is sometimes very slight, scarcely 
attracting notice ; sometimes severe, causing unpleasant 
sensations, and exciting alarm. Sleep ceases to refresh, 
food to give strength and vigor. The aspect of the patient 
changes ; the countenance is pale, expressive of languor, or 
red with the hectic flush. The" skin is less elastic ; the 
muscles less firm ; menstruation is tardy or entirely want- 
ing ; emaciation becomes evident. If these symptoms have 
appeared in the spring-time, by the use of proper remedies, 
and regimen, they are almost entirely removed, until the 
returning autumn and winter bring them on with increasing 
severity. Occasionally they seem to arise from bronchitis, 
pleuritis, pneumonitis, or some febrile disease. When 
they succeed to measles or scarlet fever, they frequently 
progress with unbounded rapidity. The rational symp- 
toms are subject to much variation. In most cases, how- 
ever, a short, dry cough is one of -the first symptoms that 
excites alarm. Often very slight, a mere hacking in the 
morning, it steadily increases, and at length is accompa- 
nied with a frothy expectoration of transparent mucus, and 
afterwards of yellow, opaque matter. Slight dyspnoea 
occurs when the patient exercises. About the sides and 



124 PHTHISIS. 

shoulders there are fugitive pains. Slight hemorrhage 
from the lungs occurs ; at times it may be somewhat co- 
pious, but often in small quantity. As the disease pro- 
gresses, the cough increases, preventing sleep, and some- 
times occurring in paroxysms. The expectoration is cor- 
respondingly increased, becoming thicker, more yellowish, 
or greenish and purulent. The other symptoms usually 
advance with equal pace. Sometimes the disease is very 
insidious in its approach. Suddenly, without any premo- 
nition, a violent attack of haemoptysis occurs, immediately 
succeeded by all the appearances of confirmed phthisis. 
These rational symptoms are intimately connected with the 
tubercular deposition. The tubercles are in a state of cru- 
dity. Softening has not yet commenced. They are in the 
form of small, roundish, homogeneous bodies, collected in 
clusters, or more widely disseminated through the lungs 
in the form of miliary tubercles. Sometimes they are more 
or less firm, of a greyish color, or translucent. 

Physical Signs. — In the nascent state of phthisis, we 
cannot derive positive information from physical explora- 
tion. In order to produce abnormal sounds on percussion 
and auscultation, the deposit of tubercles must be conside- 
rable ; or there must be in some one part of the lungs, be 
it ever so limited, a deposit sufficiently great to interfere 
with the pulmonary functions. 

If the tubercles are small and scattered, the physical 
signs will not be so sure to detect the morbid changes. If, 
on the contrary, they are large and clustered together, 
abnormal sounds are more readily developed ; so that it is 
evident that the physical signs cannot determine the accu- 
rate amount of tuberculous deposition ; since the arrange- 
ment of tubercles, as well as their number, has a modify- 
ing influence. Shall we therefore conclude that the phy- 
sical signs are of no practical utility? As well might we 
deny the usefulness of the telescope, because it does not 



PHTHISIS. 125 

reveal all the minute phenomena of the heavens. Because 
no one of the physical signs is absolutely pathognomic, we 
should not conclude that their evidence, added to that 
afforded by the general symptoms, is not of great value. 
These signs, found at the point most subject to tubercular 
disease, the comparative rarity of any other lesions capable 
of producing the same physical phenomena, enable us to 
arrive at a degree of probability which is almost equiva- 
lent to certainty. The existence of the twofold evidence 
given by the general symptoms and the physical signs, 
makes the diagnosis far more sure than it could be when 
founded only on one class of symptoms. 

Inspection is often a valuable means of diagnosis. 
Prominence of the clavicles, contraction of the intercostal 
spaces, a flatness of the chest in front, an unequal height 
of the shoulders, a, depression of the ribs, — all these, when 
present in a tuberculous patient, indicate the presence of 
phthisis. 

Percussion is usually somewhat dull under the clavicles. 
An inequality in its degree on opposite sides of the chest, 
and at points equally distant from the median line, adds 
much more significance to this physical sign, and especially 
if the dulness is greater on the left side. In emphysema 
and pneumo-thorax a similar inequality of sound may 
exist. 

In these instances the diseased side is most sonorous ; 
but the respiration is most feeble where the resonance is 
greatest, a circumstance which distinguishes this condition 
from phthisis. An emphysematous condition of the lung 
occurring adjacent to the location of solidification from 
tubercles, may cause the percussion to remain nearly nor- 
mal. Were this coincidence common, it would certainly 
diminish the value of percussion in diagnosis. But it is of 
very rare occurrence. The signs derived from percussion 
should be sought about the clavicular and acromial regions. 
11* 



126 PHTHISIS. 

Obscurity of resonance being detected beneath one or 
both clavicles, or at any point of the chest near to the 
apices of the lungs, what conclusion should be formed as 
to the nature of the disease ? To this question Chomel 
replies: — "Obscurity of sound, and feeble respiration 
under one of the clavicles, give strong reason to suppose 
the existence of tubercles, for partial effusions take place 
in the immense majority of cases at the inferior and pos- 
terior parts of the chest, and it is almost never that chronic 
pneumonia is primitive and without the presence of 
tubercles. 

In the early stage, the slightest difference of note or 
pitch on opposite sides of the chest, if confined to the 
clavicular and acromial regions, should excite suspicion. 
Although the dulness may be confined to a small locality 
over the top of the shoulders and the scaleni muscles, yet 
if it be clearly perceptible it is a very sure indication of 
the existence of phthisis. 

Auscultation, in the first stage, reveals a feebleness of 
respiratory murmur in the sub-clavicular region. This 
occurs where percussion is dull, and at the same time the 
resonance of the voice is greater than normal. While in 
one part of the lung these signs are heard, in another the 
respiration is blowing. A slight difference of sound in 
relative situations on both sides, does not necessarily 
indicate phthisis. The anatomical relations of the lungs 
have a modifying effect. A sound in the right lung of a 
phthisical patient should not be considered as indicative 
of tubercles, unless it is decidedly blowing. But if the 
respiration is more blowing at the apex of the left than at 
that of the right lung, there can be but little doubt that 
tuberculous disease is present. With the advance of the 
disease, the respiration becomes somewhat rough, or even 
bronchial, with a prolongation of the expiratory sound, 
which is one of the most striking characteristics of tuber- 



PHTHISIS, 12t 

culous deposition. Inspiration is at times somewhat jerk- 
ing. The cardiac pulsations are more audible than nsual. 
Bronchial respiration and bronchophony are heard out of 
their natural locality, thus becoming indications of pulmo- 
nary lesions. 

Second Stage of phthisis may be considered as beginning 
with the softening of tubercles, and terminating when 
cavities are fully formed, and all the physical effects arising 
from them fully developed. In other words, it is the 
forming stage of vomicae. 

General Symptoms. — Of the general symptoms collec- 
tively, I remark that they are more severe. The evening 
chills are more constant and troublesome ; the succeeding 
heat is more intense and more general, the morning sweats 
more regular and copious. Hectic is more constant, and, 
to use the words of another, " hangs out upon the cheek 
the red flag of death;' 7 the pulse is more frequent, the 
respiration quick and laborious, even when the patient is 
at rest. Languor and weakness increase, emaciation is 
rapid, the muscles are soft and flabby, and the patient 
can no longer endure his wonted amount of physical or 
mental exertion. Paleness of the countenance frequently 
remains through the early part of the day. Sometimes 
there is a greater tendency to chills shown by an increased 
sensibility to cold, and the evening exacerbation brings on 
an increased heat of the palms of the hands and the soles 
of the feet. The countenance, under the influence of the 
morbid excitement, is for a while more animated, the eye 
brightens, and the red blush of hectic gives to the features 
new beauty and loveliness. When speaking, the lips of 
the patient slightly quiver, there is breathlessness which 
interrupts him in the middle of a sentence. Sleep is more 
disturbed. Xot unfrequently the mind, even in this stage 
of the disease, is buoyant and hopeful. The least or most 
temporary amendment in his symptoms, or the delusive 



128 PHTHISIS. 

promises and boasts of quacks, inspire him with, the joy of 
hope. The Physical Signs in this stage are more marked. 
As the disease advances, the tubercles soften and become 
diluted with a morbid secretion from the pulmonary 
tissues. Particles of curdy or cheesy matter pass from 
their locality, in the parenchyma of the lungs, into the 
bronchial tubes, and are expectorated. The exit of this 
matter from the lungs gives rise to little vacuities called 
caverns, cavities, vomicae or excavations. A careful ex- 
amination of the chest, at this time, affords positive evi- 
dence of the internal mischief. The upper parts are less 
freely raised during respiration than in the healthy state ; 
this phenomenon frequently being more evident on one 
side than on the other. The sub-clavicular regions on 
both sides, give a dull sound on percussion. To the 
mind, the ear, or stethoscope, when applied to those 
portions of the chest situated where percussion is dull, 
reveals a slight crackling noise — the crepitating rhonchus. 
After vomicae are formed, the cavernous rale or the 
gurgling is heard, when the cavity is partly filled with 
liquid. Resonance of the voice and cough, and at length 
pectoriloquy follow. If a solidified portion of lung, en- 
closing a considerable bronchus, comes near to the surface 
of the chest, then bronchial breathing and bronchophony 
are heard. Percussion, too, will give the same sound, 
whether the lung be hepatized or blocked up by tubercular 
matter. This condition of the lungs may be present in 
one part, while cavities exist in another, and therefore, 
different parts of the chest will exhibit different physical 
signs ; I have said that the gurgling sound is heard in 
case the vomicae contains liquid. But does this sound 
necessarily prove in all cases the existence of cavities ? 
Dr. Watson remarks, "that where we hear, during inspira- 
tion, the gurgling rale — called by Laennec, gargouillement 
— we may conclude, that there exists a cavity. But the 



PHTHISIS. 129 

cavity will not necessarily be a vomica. In ninety-nine 
cases out of a hundred, it will be so ; but in the hun- 
dredth, perhaps it will not." 

Dilatation of the bronchi, sometimes produces a con- 
siderable globular expansion. In case these cavities, 
formed by such an expansion, were filled with a liquid, the 
same sound would be produced, as that caused by tuber- 
cular vomicoe. 

Third Stage. — The third stage is that period, which 
commences when cavities are already formed, and con- 
tinues until the termination of the disease. This has 
been called the colliquative stage, from the copious per- 
spiration, the frequent attacks of diarrhea, and the abun- 
dant expectoration with which it is attended. The feet 
and ankles become (edematous ; the vital powers gradually 
decrease, one after another ; the functions of life fail ; the 
body, by a facilis descensus, falls to the earth, and the 
soul rises to eternity, 

General Symptoms. — The most important of these are, 
the colliquative sweat, diarrhaea, extreme emaciation, 
anasarcous swelling of the lower limbs, and high febrile 
excitement, A sure indication of approaching dissolu- 
tion, is an aphthous condition of the mouth. This usually 
comes on during the last weeks, or days of existence. 
The mental faculties, at this period of phthisis, are more 
or less deranged. Keason remains ; but it is not the 
reason of health. Slight delirium sometimes occurs ; the 
patient becomes indifferent to what is passing around him, 
and to his own state, when a little while before his atten- 
tion was aroused by every unfavorable symptom. 

Special Symptoms. — The expectoration is very copious, 
consisting of a heterogeneous mass of mucus, pus, soft- 
ened and occasionally solid tubercle, blood, shreds of 
lymph, rarely portions of pulmonary tissue, sometimes 
very fetid. The cough and dyspnoea increase. The 



130 PHTHISIS. 

shoulders are raised and brought forward ; the chest is 
narrow and flat. During respiration, the clavicular 
regions are less moveable than natural, and when the 
patient attempts to make a full inspiration, the upper part 
of the thorax, instead of expanding with the appearance 
of spontaneous ease, peculiar to the healthy state of the 
lungs, seems to be forcibly dragged up at each respiratory 
effort. 

Physical Signs. — The physical signs in the third stage, 
are similar to those in the second. The gurgling rale, the 
increased resonance of voice, bronchophony, and pecto- 
riloquy, amphoric resonance, and metallic tinkling, may 
be present in different cases and at different times. Some 
of these signs are more frequently heard than others. 
The metallic tinkling is oftener present in a large than in 
a small cavity ; and since large cavities are formed in the 
third stage, this symptom is observed only when the dis- 
ease is far advanced. 

Haemoptysis. — This is the most important rational 
symptom that occurs in phthisis. In other diseases and 
conditions of the lungs, it is so rare that it very certainly 
indicates the nature of the case. Haemoptysis, to be sure, 
may be produced by other causes — by certain forms of 
heart disease, by cancer, by cirrhosis of the lungs ; and, in 
females, by vicarious menstruation. But these latter con- 
ditions of the lungs are very rare, and therefore haemoptysis 
should be considered a strong evidence of phthisis. 

Emaciation. — This is one of the cardinal symptoms of 
phthisis. Frequently it precedes the other symptoms. 
Between the ages of forty and fifty, Dr. James Clark found 
it one of the earliest symptoms of this disease. Indiges- 
tion is regarded by the patient and his friends as one of the 
principal causes of this atrophy. It is frequently associated 
with anaemia. There is many times a peculiar physiog- 
nomy ; the cheek is pale and thin, and the eye bright. 



PHTHISIS. 131 

Every organ in the body, except the liver and the heart, even 
the blood itself, emaciates. And this is often the first 
symptom noticed. At length slight disturbance is mani- 
fest — a little dyspnoea, a little chilliness towards evening, 
and a tendency to cough. This symptom, emaciation, is 
not always progressive. The patient may gain flesh, but 
he soon loses it again ; then perhaps gains awhile in 
weight ; and so on alternately. This, however, is observ- 
able : he seldom gains as much as he loses. There is a 
gradual though not a continuous descent. It is true also, 
that while there is an increase of weight, the tuberculai 
disease advances ; and while the patient and friends are 
elated with hope by the apparent amendment, a fatal ter- 
mination steadily approaches. Loss of appetite and 
diarrhsea very much increase the emaciation. 

Diarrhcea. — The rapidity of the progress of consump- 
tion very much depends upon this. With the number of 
evacuations Louis found that the loss of strength corre- 
sponded. This fact should militate against the employ-" 
ment of cathartics in phthisis. "A tablespoonful of castor 
oil," says Dr. James Clark, "I have seen throw a phthi- 
sical patient into an alarming state of debility." In those 
who have in health a costive state of the bowels, incipient 
phthisis produces regularity of action. DiarrKsea is usually 
confine-d to the advanced stage of the disease. In one- 
eighth of- the cases treated by Louis, diarrhaea commenced 
with the disease, and continued until its termination ; in 
the majority it occurred in the later stages ; in others 
during the last days of life ; and in four out of one hun- 
dred and twelve cases, it never appeared. The distress 
attending this symptom is often severe ; before each 
evacuation the pain is often intense, and immediately after 
it there is a deadly sensation of sinking. It has an effect 
upon the cough and expectoration. 

The severity of these symptoms is usually in an inverse 



42 PHTHISIS. 

>atio to that of the diarrhaea. As a diagnostic sign it is 
T,,ot of great value. The nature of the disease is known by 
$tber means, before this becomes fully developed. The 
cause of the diarrhaea is the softening of the tuberculous 
matter deposited among the coats of the intestines. After 
death we find ulceration of the mucous membrane, tubercu- 
lous deposits thickening and softening, and enlarged mu- 
cous follicles, especially near the termination of the ileum 
and in the colon. 

(Edema. — This is an invariable attendant of the last 
stage of phthisis. In young delicate females it may super- 
vene in the earlier stages. Generally it shows itself first 
in the lower extremities, and is confined to them. In the 
morning there is sometimes an cedematous appearance in 
the face. For the diagnosis this is of no value ; but it is 
a prognostic of approaching death. Is the suppression of 
the menses the cause of the tuberculous disease ? Some 
have thought it might lead to tubercles in the lungs. The 
menstrual suppression is for the most part the effect of that 
general debility, that deficiency of the nutritive properties 
of the blood which precedes the deposition of tubercles. 
If this theory is true, then the treatment, instead of being 
wholly directed to the restoration of the uterine functions, 
should be directed to remedy that deficient nutrition 
and its consequent debility, which cause the menstrual 
suppression, §nd the tuberculous deposition. The cessa- 
tion of the menses is sometimes one of the first, if not the, 
first, prominent symptom of phthisis ; and a careful exami- 
nation of the case will often discover this to be the fact. 
Attendant upon this symptom there are, in most cases, a 
slight cough, a little chilliness and fever, and some of the 
physical signs of incipient phthisis. In general this func- 
tion continues, but decreases in quantity, during the early 
stage of the disease. From a gTeat variety of causes, this 



PHTHISIS. 133 

function is so liable to derangement, that as a diagnostic 
sign it is not of much value. 

Duration of Phthisis. — Tuberculous phthisis is essen- 
tially a chronic disease, the range of its duration being 
considerable. Cases have been recorded which have ter- 
minated in eleven days, while others have lingered for 
twenty or even forty years. These, however, are extreme 
cases ; the majority terminate in one or two years, the 
average duration being eighteen months. 

Phthisis in Infancy and Childhood. — Phthisis is more 
common in infancy and childhood than was once supposed. 
Dr. G-uersent, one of the physicians to the Hospital des 
Enfans Malades, an institution appropriated to the treat- 
ment of patients between the age of one and sixteen years, 
gives, as the result of his observations, that five-sixths of 
those who die in that hospital are more or less tuberculous. 
Early in life, its existence is manifested by symptoms 
somewhat different from those, of adults. The cough 
occurs in paroxysms ; hectic expectoration and hemor- 
rhage from the lungs are not so apparent. The tuberculous 
cachexia, rapid pulse and breathing, emaciation and 
derangement of the digestive organs, tumid abdomen and 
irregular action of the bowels, at one time constipated, at 
another affected with diarrhoea, and the pale unnatural 
color of the evacuations, point out the nature of the disease. 
In children the mesenteric glands are more subject to 
disease than in adults. But the most frequent seat of 
tuberculous affections is the bronchial glands, and the next 
in frequency is the lungs. The relative frequency of 
tubercles in the bronchial glands of children, compared 
with the lungs, is not less than five to four, which is 
. reversed after the age of puberty. 

12 



134 PHTHISIS. 

CAUSES OF PHTHISIS. 

Among the causes of phthisis, hereditary predisposition 
occupies the most important place. And yet this heredi- 
tary tendency explains nothing in relation to the real cause 
of the disease. It is the name of a fact, not a cause, which 
is sure to produce specific results. We must, therefore, 
in order to arrive at anything definite or practical, seek to 
find that in which the fact has its origin — whether it is a 
peculiar state of the blood, or a want of functional power, 
— in the digestive organs, or in the respiratory apparatus. 
Vitality is the effect of so many conditional causes, each 
liable to vary in intensity, and by that variation to influence 
the result — the degree of vitality, — that it is difficult to 
tell in what ultimate change phthisis has its origin. But 
the nearer we can ascend to the sources of knowledge, the 
more general and conditional that obtained knowledge 
becomes, for all other knowledge relates to it as species 
to genera. Accordingly, it is evident that if chemistry 
or optics could detect that condition of the blood, whatever 
it is, which is most prevalent in the progeny of tuberculous 
parents, before deposition of tuberculous matter takes 
place, a general fact would be obtained of more value than 
many particulars often spoken of by medical writers. From 
pathology or from chemistry we gain no evidence that 
those who are predisposed to phthisis have blood essen- 
tially differing from that of others. And the existence of 
the hereditary tendency has been questioned by some recent 
observers. But because of the non-appearance of an ab- 
normal change in the constituents of the blood, except in 
rare cases, or because the existence of that tendency is 
denied, we should' not therefore conclude that hereditary 
influence does not exist, It may exist, but not as an 
ultimate cause, ever producing a certain result. 

Occupations of Life. — Concerning the causes of phthisis, 



PHTHISIS. 135 

Lombard, of Geneva, has given us some valuable statistical 
information. The result of his researches is thus stated : — 
The circumstances which increase the tendency to phthisis 
are poverty, sedentary habits, violent exercise of the chest, 
an habitually bent position of the body, impure air in 
workshops, the inhalation of certain mineral and vegetable 
vapors, or air loaded with a coarse or impalpable dust, or 
with light, thready, elastic substances. 

The conditions which seem to exert a favorable pre- 
servative influence, are easy circumstances, an active life in 
the open air, regular general exercise, the inhalation, of 
watery vapor, and animal and vegetable emanations. 
Sedentary habits are prone to produce phthisis. The 
habit of sitting with the body inclined forward, thus pre- 
venting the free expansion of the lungs, and the action of 
the stomach, and other abdominal viscera, is one cause of 
the injurious tendency of a studious life. Among shoe- 
makers and tailors, the proportion of phthisical patients is 
very large. 

Dyspepsia. • — In dyspeptic diseases, many authors have 
placed one prominent cause of phthisis ; and with good 
reason they have done so. For since tubercles depend for 
their development upon a want of nutrition in the blood, and 
since dyspeptic diseases deprive the blood of its nutritive 
properties, there is every reason to believe, that in this 
source tubercles have their origin. 

There are other causes of phthisis, seldom described in 
medical works. Of these, one is masturbation, which, by 
its debilitating effects upon the general constitution, tends 
in an eminent degree to favor the development of tubercles. 
Another cause is the use of such remedial agents in the 
cure of disease, as leave after their primary effects have 
subsided, secondary ones, which in the end prove worse 
than the original disease. If this be so, and the history 
of thousands of individuals corroborates its truth, then 



136 PHTHISIS. 

why may not its action upon the system- directly induce 
tuberculous disease ? Indirectly, if not directly, by debili- 
tating the system deteriorating the red blood, and inducing 
emaciation, it so influences the mass of the fluids, as to 
predispose the system to the ingress of phthisis ; it leaves 
the territory unguarded by any vital force, even by that 
mysterious one, "the vis medicatrix naturce." A patient, 
somewhat predisposed to phthisis, takes a severe cold in 
the autumn. Febrile symptoms supervene. There is, ac- 
cording to the opinion of some, an exalted condition of 
vital action ; and consequently, all the instruments of the 
antiphlogistic regimen and treatment, are immediately 
used to subdue the inflammation. After a number of 
weeks, the patient may slowly recover. But his digestive 
organs do not seem to be healthy. Strength does not 
return ; a slight cough begins, and in from six months to 
a year, phthisical symptoms are fully developed. Such 
cases often occur, and so often, that the more judicious 
physicians of all creeds, even those standing on the con- 
servative platform, now begin to abandon the use of de- 
pressing remedies ; not because as some often pretend, dis- 
eases are now so different in their nature, as not to require 
the same treatment, but because the application of science 
to the study of medicine, has exploded the idea that it is 
necessary to hazard life, by the use of deleterious agents, 
in order to produce a speedy and complete cure. 

Prognosis. — In those cases where the disease is far 
advanced, the prognosis is always very unfavorable. So 
small is the chance of recovery, that the physician has no 
good reason to encourage either patient or friends. 

But morbid anatomy has demonstrated, that even in the 
last stages, recoveries do take place ; the cavities are filled 
with chalky concretions, their parietes contract, and cica- 
trices are produced. What else than the cure of phthisis 
do such facts teach ? On this subject, Dr. Swett remarks, 



PHTHISIS. 137 

"I never shall entirely despair of the life of a patient, 
when I recollect what I once witnessed in this Hospital. 
A patient was admitted with phthisis. The disease was 
perfectly well characterized, and in its roost advanced 
stage ; a large and well-marked abscess existed under the 
right clavicle. Indeed the signs of this lesion were so 
distinct, that I was in the habit of calling the attention, 
of students in attendance, to them, as perfect in their cha- 
racter. On one occasion, as I approached the bed for this 
purpose, I found the patient, who had been gradually 
sinking, in such a state that it seemed to me improper to 
disturb him. He was bolstered up in bed, with his head 
falling upon his shoulder, breathing with great difficulty, 
bathed in perspiration, and with a rapid and feeble pulse. 
The next day my attendance ceased, and after two months 
was again commenced. On entering the ward, the house 
physician called my attention to a man, dressed, and walk- 
ing about the ward, apparently stout and well, although 
somewhat pale. To my great" astonishment, it was the 
patient I had left two months before, apparently dying. " 
The same author testifies that he has known a number of 
cases of patients, who have had all the evidences of 
phthisis, and yet have recovered. 

TREATMENT. 

11 The indications to be fulfilled in the treatment of this 
disease," says Prof. Calkins in his very excellent work on 
thoracic diseases, "are, first, to prevent the farther depo- 
sition and development of tubercles ; and, secondly, to pre- 
vent and to protect, as far as possible, the lungs and other 
organs from their injurious results. The means both pro- 
phylactic and remedial, which can be of any utility for this 
purpose, must be directed to the attainment of this result : 
the production of that state of the solids and fluids which 
is most adverse to the development of tubercles." Prof. 
12 * 



138 PHTHISIS. 

J. G. Jones says : " The leading indications to be fulfilled 
in the treatment of this disease are twofold, to wit : 1. To 
change the condition of the blood, and restore the qualities 
pertaining to its healthy state. 2. To prevent the further 
deposition and development of tubercles, give tone and 
vigor to the whole system, and in a measure change its dia- 
thesis. " Profs. Newton and Powel, in a work on the 
treatment of diseases, make the following remarks : "In 
the treatment of this disease, little else can be done than 
to make use of means which will enrich the fibrinous por- 
tions of the blood, strengthen the nervous and muscular 
system of the patient, and relieve troublesome and danger- 
ous symptoms as they may appear." Dr. Walshe gives the 
results which he obtained in the Consumption Hospital as 
follows: "1. Of a given mass of patients entering the 
hospital in all stages of the disease, and in every variety 
of general condition — between the actual moribund state 
and that of but slight constitutional suffering— the number 
leaving it, on the one hand, improved or unadvanced was 
more than double that, on the other hand, leaving it in a 
worse state or dying within its walls (the exact ratio is 
61*84: 32*16). If the cases in which death was actually 
imminent at the period of admission, were excluded, the 
result would be very materially more favorable than this. 
2. In 4 26 per cent, of the cases, complete restoration to 
health, not only as regards apparent disturbance of the 
functions generally, but as regards local evidence of actual 
pulmonary disease, was effected. 3. Complete removal 
of symptoms was more frequently effected in the male than 
in the female ; but, on the other hand, the results were on 
the whole slightly more favorable in the latter than in the 
former sex. 4. All patients who grew worse while they 
were in the hospital had reached the stage of excavation 
on admission; and all patients whose tubercles were yet 
unsoftened on admission, left the hospital either improved, 



PHTHISIS. 139 

or having bad a statu quo condition kept up. Improve- 
ment is more probable than the reverse, even where exca- 
vation exists on admission. 5. In a given mass of cases, 
the chances of favorable influence from sojourn in the 
hospital will be greater in a certain (undetermined) ratio 
as the duration of the disease previous to admission has 
been greater ; in other terms, natural tendency to a slow 
course is a more important element of success in the treat- 
ment of the disease, than the fact of that treatment having 
been undertaken at an early period. 6. The mean length 
of stay in the. hospital, in the most favorable class of cases, 
nearly doubled that in the least favorable. 7. The chances 
of benefit are most in favor of those whose trades are pur- 
sued out of doors (wholly or partially) than of those who 
work wholly within doors. 8. The results did not appear 
to be influenced by the laborious or non-laborious charac- 
ter of the trade individuals might have pursued. 9. The 
age of the sufferers did not appear to exercise any very 
material influence on the character of the results. 10. 
Patients coming from the country have, on an average, a 
slightly stronger chance of improvement than the residents 
of London and its suburbs. 11. Patients admitted during 
the warmer half of the year, benefit by a sojourn at Bromp- 
ton, to a slight extent, more than those received during the 
six colder months. " 

From the above facts, together with the experience of 
every intelligent Eclectic physician, it appears that pulmo- 
nary consumption is occasionally cured, and sometimes 
terminates favorably without medical aid ; and perhaps I 
might state, in spite of medicinal treatment. But when 
we consider the irrational treatment which has been relied 
upon for the cure of this disease, we can hardly be sur- 
prised at its fatality. Xor that not only the medical fra- 
ternity, but the community generally, have been led to be- 
lieve that it is incurable. So much so is this the case, that 



140 PHTHISIS. 

a large number of physicians deem it a sufficient apology 
for losing a patient in the prime of life, to state that he 
died of pulmonary consumption. I do not expect in this 
article to lay down a course of treatment that will always 
oure, irrespective of age, condition of the patient, and 
stage of the disease ; but, I do expect to explain such 
a course, as will, if properly applied, cure a large pro- 
portion, and materially relieve such as cannot be entirely 
restored. 

When a person exhibits premonitory symptoms of 
phthisis, every exciting cause of the disease should be 
removed. The patient should exercise freely in the open 
air, and be placed upon a full and nutritious diet, such 
as beef-steak rare cooked, &c. He should also take a 
reasonable quantity of some stimulant, as brandy toddy, or 
some malt liquors, before each meal. If this does not 
remove those early symptoms, chalybeates, in connection 
with sugar, may be given as follows : 

U Precipitated Carbonate of Iron spj. 

White Sugar gvij. 

Mix and triturate, take one teaspoonful three or four times 
a day. Should the beef, and other articles of food, not be 
well digested, on account of a dyspeptic habit which fre- 
quently precedes this disease, slightly cooked eggs and rich 
animal soups may take their place. This course has been 
efficient in my hands in a large number of cases, where the 
early symptoms of phthisis were developed. But where 
the disease is farther advanced, with more or less anemia, 
cough and expectoration, with depression beneath the 
clavicle, feeble respiratory murmur, and dulness on per- 
cussion, and especially if there is connected with this a 
tubercular diathesis, then much effort will be required to 
prevent a disastrous encroachment of the disease. In this 
condition and stage of symptoms, the following treatment 
should be instituted. 



PHTHISIS. 141 

A large double flannel cloth, within which has been 
quilted a liberal quantity of coarse suit, should be placed 
over the chest and back in such a manner as to protect 
both the anterior and posterior portions of both lungs. 
This salt pack should be changed from time to time, but 
should be worn until the disease is removed. And for 
supplying those deficiencies of the blood, which are such a 
prolific cause of pulmonary consumption, give the following 
compound : 

R The white ot eggs xij. 

Iron by Hydrogen gr. xx. 

Phosphate of Lime gij. 

Chloride of Sodium giij. 

Mix with one pint of best brandy, one pound of sugar, and 
one pint of water ; dose one tablespoonful three or four 
times a day. In connection with this, the patient should 
exercise freely in the open air, and should make a liberal 
use of warm or cold baths, as the case may seem to indi- 
cate. If there are chilis, 

U Quinine , gr. xx. 

Phosphate of Iron ., gr. x. 

Morphine , gr. jss. 

White Sugar gr. xxx. 

Mix, triturate, divide into fifteen powders, and take one 
every three hours. If the first fifteen powders fail to 
interrupt the chills, they should be repeated from time to 
time, until they cease entirely. If there is troublesome 
cough, with dyspnoea, give the following mixture : 

U Simple Syrup of Stillingia giij. 

Syrup of Tolu gij. 

Morphine , gr. ij. 

Mix; dose, one teaspoonful three times a day, and oftener 
if required. If there appears to be bronchial irritation, 
from one-eighth to one-half a grain of Gelsemin should be 
taken at bed-time. If the salt pack should be removed 



142 PHTHISIS. 

at any time during the treatment, the chest should be well 
protected by oil silk or flannel. In nearly all cases of 
pulmonary consumption, there is a deficiency of the natural 
covering, the hair. In fact, so general is this the case, 
that I have come to regard a deficiency of hair on the 
chest as one of the indications of a tuberculous diathesis. 
For the hair is not simply an ornament, but it serves 
to separate certain proportions of carbon, silica, sulphur 
and other materials from the blood. As the disease 
advances to the latter part of the second stage, other 
symptoms make their appearance, as diarrhoea, and a 
muco-purulent matter or pus, constituting the sputa, indi- 
cating a breaking down of the tuberculous deposit, with 
more or less affection of the glands of the bowels. To 
control the diarrhsea, no medicine is more effectual than 
the following : 

U Sub-nitrate of Bismuth gr. xx. 

Quinine gr. xvj. 

Pulverized Gum Arabic gr. xxx. 

Mix, triturate, divide into twenty powders, and give one 
every five or six hours until that symptom is controlled. 

The method of treating this disease by introducing 
medicine into the system by inhalation, having received 
much attention of late, I will quote the remarks of Dr. 
Turnbull upon the subject, as they appear to embrace most 
of the facts essential to it. 

" Dr. Snow has shown, in a paper on the inhalation of 
various medicinal substances, that some must be inhaled by 
the aid of heat, such as opium, morphia, extract of stramo- 
nium, and the gum resins ; others with heated vapor, such as 
iodine, camphor and creosote, and a third class of sub- 
stances, such as hydrocyanic acid, ammonia and chlorine, 
at the ordinary temperature. Mead, in his day, recom- 
mended fumigations with the balsams in phthisical cases, 



PHTHISIS. 143 

and Dr. A. T. Thomson (Cyclopedia of Medicine, Art. 
Expectorants) has stated that he has seen much benefit 
derived from them, when inhaled in spasmodic asthma, in 
shortening the paroxysm, and promoting expectoration. 
Dr. Snow found that ammoniacum gives off a fragrant, 
rather pungent odor, which can be inhaled very well by 
most persons. He also found inhalation of the watery 
extract of opium serviceable in relieving the cough ; but 
that morphia was the most pleasant and suitable prepara- 
tion of opium for inhalation. Extract of stramonium 
afforded more or less relief in five or six cases of asthma. 

He tried iodine in eighteen cases of consumption at 
Brompton Hospital ; in ten of them it was continued for 
more than a month ; and the conclusion to which he came, 
was that no benefit could be observed to follow its use. 
Oil of turpentine appeared to relieve the cough in a few 
cases, and likewise camphor. He used the volatile alka- 
loid conia in the quantity of one minim, diluted with 
nine of spirit ; the cough was usually relieved, and in two 
or three cases the breathing also. It would seem, there- 
fore, from its volatility at the ordinary temperature, to be 
a remedy peculiarly suitable for inhalation, if it could be 
obtained more easily. Dr. 'Snow also found great relief 
in a few cases of bronchitis with difficult expectoration, 
from inhaling ammonia, twenty drops of the strong solu- 
tion being mixed with two ounces of water in a Woulfe's 
bottle. Chlorine has been used for inhalation ; it was 
introduced for this purpose in France, and there is good 
reason to believe that it has proved of material service in 
cases of chronic bronchitis, and even in some of phthisis. 

With reference to its use in this latter disease, Dr. 
James Clark has observed, "We have tried it in many 
instances, and it has in several, apparently suspended the 
progress of the disease. ' r He also states that it relieved 
dyspnoea and cough in some cases, though in the majority 



144 PHTHISIS. 

it procured no amelioration. Dr. A. T. Thomson has 
likewise stated, that in cases of asthma, the relief it pro- 
duced was very striking, and that in phthisis, he had 
observed the hectic symptoms abate. 

Of the various remedies now mentioned, it is probable 
that gum resins and balsams, camphor, conia, and chlo- 
rine, are the most suitable and useful for inhalation ; but it 
does not appear that by inhalation of opium, or morphias, 
very decided advantage has been gained over the ordinary 
mode of exhibiting them. 

The vapor of tar was formerly recommended for inhala- 
tion, and few medicines have been more used for this 
purpose than creosote. Sir Alexander Crichton, in 1828, 
strongly recommended tar vapor in consumption ; but 
Dr. Forbes, in a report of cases in which he had tried it, 
published in the Medical and Physical Journal, stated 
that he found it injurious in this disease, though of service 
in some cases of chronic bronchitis. He appears, how- 
ever, to have used it in cases so far advanced, that no 
benefit could reasonably have been expected from its 
employment. Creosote has now superseded the use of 
tar vapor, which does not, from its irritating properties, 
seem well suited for inhalation, though there can be very 
little doubt, when we consider the healing power it has in 
external application, that it must exert a similar effect 
upon the lungs, if it could be used in such a form as to 
obtain its beneficial influence apart from its irritating pro- 
perties. Creosote is perhaps more generally used by the 
profession for the purpose of inhalation, than any other 
remedy ; and I believe that when sufficiently diluted with 
vapor of water, it is one of the most useful. I have 
found that it has a sedative influence, relieving cough and 
promoting expectoration, whilst it at the same time not 
unfrequently lessens the quantity of this secretion, both in 
consumption and bronchitis. I have already observed 



PHTHISIS. 145 

that the pyrogenic bodies act upon the mucous and cu- 
taneous surfaces ; and my attention has been directed to 
other bodies of this class, by the fact that many of them 
have remarkable healing properties, when applied to 
ulcers and chronic cutaneous eruptions, a fact which leads 
me to expect that this class of bodies may, when fully 
investigated, furnish a suitable remedy for promoting the 
healing of pulmonary ulcers, and thus supply the deside- 
ratum to which I have previously alluded. Many of the 
pyrogenic bodies possess such healing properties in cu- 
taneous diseases, in a greater or less degree. From my 
own experience, I know that ointments, made with tar, 
creosote, spirit of tar, juniper tar oil, and naphthaline, 
have such properties, and are valuable remedies in the 
treatment of skin diseases. 

The inference drawn from these facts, has led me to use 
for inhalation, some other pyrogenic bodies, viz : spirits 
of tar, juniper tar oil, Persian naphtha, and enpione, The 
spirit of tar possesses the healing virtues of tar without 
its irritating effects ; so much so, that I think it might 
advantageously supersede the crude substance as an 
external remedy. It is more readily volatilized than creo- 
sote ; and when inhaled, it produces generally a mild, 
stimulating, and often rather a soothing effect upon the 
lungs. In some instances, however, it has appeared to 
increase the cough and expectoration, and it is not, there- 
fore, suited for bronchitis, until inflammatory action has 
been subdued completely ; or for cases of consumption, 
until progress has been made in arresting the disease. 
Without wishing to speak confidently of the remedy, I 
may state that it has appeared useful in some cases of the 
latter disease, in conjunction with other treatment. Juniper 
tar oil (oleum codinum), which is a valuable remedy in 
skin diseases, and much used on the Continent, is less 
volatile than spirits of tar, and is less irtitating when 
13 



146 PHTHISIS. 

inhaled. Persian naphtha and eupione possess decided 
anaesthetic properties ; the former, when inhaled along 
with the vapor of water, has in some instances relieved 
difficulty of breathing in a very remarkable and decided 
manner ; and ttiis fact renders it worthy of trial in spas- 
modic asthma. Eupione has decided sedative properties : 
it has relieved cough and difficult breathing, and patients 
have slept well after using it ; but it is not a pleasant 
remedy to inhale, and it has not unfrequently produced 
sickness afterwards, so that I should not recommend it to 
be used for this purpose. 

I have used several of the essential oils for the purpose 
of inhalation. Many of them possess decidedly anti- 
spasmodic properties, and I have found that they have a 
remarkably strong power over difficulty of breathing, a 
property which renders them peculiarly suitable for reliev- 
ing spasmodic asthma. The oil should be dissolved in 
spirit, and inhaled with the vapor of water, so as to dilute 
its stimulating properties. The oils of cubebs and copaiva, 
which are hydro -carbons, are mild in their action, and - 
produce very little stimulating effect. The oxygenated 
oils which I have used appeared to be more stimulating in 
their action on the air-tubes, and some of them have 
stronger anti-spasmodic and expectorant properties. The 
oils of anise and peppermint are very stimulating, and in 
general cause too much irritation. Oil of spearmint is 
milder and antispasmodic, relieving difficulty of breathing 
in asthma, and even in phthisis. Oil of fennel is also 
mild. The oil of origanum is moderately stimulating and 
expectorant. I have also used the oils of rosemary and 
pimento, which have similar properties. The hydruret 
of benzyle, which is the oil of bitter almonds deprived of 
its prussic acid, is very irritating and much too stimulating 
for inhalation. Chloroform is a remedy which has been 
much used by some medical men for the purpose of inha- 



PHTHISIS. 147 

lation, not only in asthma, but, in a small quantity, in 
consumption, in order to relieve irritable cough. In some 
cases I have dissolved the essential oils in chloroform, and 
used them in this way for inhalation, their volatility being 
thus so much increased that they may be given on a hand- 
kerchief, as chloroform is usually administered. 

In addition to the remedies spoken of by Dr. Turnbuli, 
Carbonate of Ammonia, Nitrate of Silver, Sanguinaria 
and Veratrum Viride have been quite extensively used by 
different physicians, and in some cases to much advantage. 
The oil of Erigeron, spoken of by Dr. Turnbuli, I have 
used quite successfully in several cases of haemoptysis, con- 
nected with phthisis, but whether it acts more efficiently in 
this way than when introduced into the stomach, I am not 
prepared to say. If the inhalation of medicine be resorted 
to, the introduction of medicine into the stomach should 
not be neglected. We can readily conceive how ineffectual 
a treatment exclusively by inhalation must prove, since the 
well established pathology of this disease shows the local 
affection of the lungs to be only one of the unhealthy pro- 
ducts of the constitution. In this stage of the disease, 
much benefit will be derived from the use of diuretics to 
relieve the blood from the excess of uric, and other acids, 
with which it becomes overcharged, and also of the dis- 
integrated tissue which accumulates in the system, owing 
to imperfect respiration. Among the best diuretics to 
accomplish this object is the following : 

R Pipsissewa , , gj. 

Indian Hemp 3J SS « 

Marshmallow gj. 

Bruise all together, and make one quart of syrup with 
white sugar, and add one half pint of best gin, and let the 
patient take from one half to one wine glass full four or five 
times a day. 



148 PHTHISIS. 

For the purpose of procuring rest at night, 

R Quinine gr. x. 

Scutellarin gr. xv. 

Gelsemin . , gr. ij. 

Iron by Hydrogen gr. xij. 

Mix, divide into ten powders, and give one every night at 
bed-time. 

Where there is great emaciation and debility in this 
stage, for supplying material for combustion, and for 
increasing the quality and quantity of blood : 

II Cod Liver Oil ." Of. 

Good Brandy Oss. 

Chloride of Sodium gij. 

Phosphate of Iron 5Jss. 

Mix, and shake well before using. Dose, one tablespoon- 
ful three or four times a day. If there is much bronchial 
irritation in connection with tuberculous affection, 

R Syrup of Stillingia gij. 

Tct. of Veratrum Viride gss. 

Mix, and give thirty drops three or four times a day. 

For the purpose of promoting absorption of the already 
existing tuberculous deposit, Prof. John Fondey, Emeritus 
Prof, of Theory and Practice of Medicine in the Eclectic 
Medical College of Pennsylvania, who has had great ex- 
perience in the treatment of this class of diseases, places 
much reliance on the use of electricity. 

In his treatise upon this subject, p. 68, he thus remarks : 
" The electro-magnetic machine constitutes one of the 
most powerful means that we possess, to accomplish the 
results so desirable in the treatment of this disease. What 
we want in the remedies which we employ, is some power 
that will excite the contractility of the coats of the vessels, 
of the enlarged absorbent glands, as well as of the lymphatic 
vessels ; give strength to the magnetic organization of the 



HAEMOPTYSIS. 149 

part, and promote the absorption of the deposits that may 
have occurred in and around these glands and vessels." 

Dr. Cartwright, of New Orleans, who has published 
several very interesting articles upon the nature and treat- 
ment of tuberculous affections of the lungs, cites quite a 
number of cases where absorption of the tuberculous depo- 
sition was effected by the inhalation of the vapor of sugar. 

I have generally obtained the most satisfactory results 
in promoting the absorption of tuberculous deposits by the 
use of Iodide of Potassium, in connection with mucilage 
The mucilage prevents the irritating effects of the Iodide 
of Potassium on the bowels. The chest should be 
thoroughly bathed twice a day with a liniment made as 
follows : 

R Oil of Stillingia §j. 

White of three eggs. 

Oil of Turpentine .; gij. 

Chloride of Sodium gij. 

Mix, and shake well together. During the entire treat- 
ment of this disease, the strictest attention should be given 
to bathing, diet, and exercise in the open air. Every 
means should be resorted to which has a tendency to im- 
prove the general health of the patient. Where the disease 
assumes a periodic character, the greatest benefit will be 
derived from administering a liberal quantity of Quinine 
and Iron every seven or eight days. When the disease is 
complicated with other local difficulties, such as leucorrhsea, 
spermatorrhea, &c, they should receive especial attention. 



HAEMOPTYSIS. 

By haemoptysis we understand expectoration of blood. 

It may occur from the mucous surface of the bronchial tubes ; 

by extravasation of blood into the pulmonary tissue, &c, 

or from the corrosion of a blood-vessel on the wall of a tuber- 

13* 



150 HEMOPTYSIS. 

culous vomica. It is also said to occur from the granula- 
ted surfaces in phthisis. The most common cause of the 
disease in females, when it occurs from the mucous surface 
of the bronchi, is vicarious menstruation, which takes 
place about the period of the catamenia. In these cases, 
for some time previous to the attack, there will be observed 
a diminution in the catamenial flow, accompanied by anae- 
mia. Indeed, we have reason to suspect that, in connec- 
tion with the catamenial derangement, there is tuberculous 
affection of the lungs. I do not recollect, out of a large 
number of cases, a single exception, and in quite a num- 
ber of cases, it has terminated in acute phthisis. When 
the blood eseapes from the bronchial mucous surface, it 
may be detected by the bubbling liquid rhonchus in the 
bronchi. The discharge is generally preceded by more or 
less constitutional disturbance, such as constipated bow- 
els, furred tongue, and cough, which is often persistent, 
and accompanied with great dyspnoea. Where it occurs 
from the rupture of corroded blood-vessels, the premoni- 
tory symptoms are quite obscure, and the discharge of 
blood is very sudden, with violent cough and dyspnoea. 
The physical sign is the mucous rale. When it occurs 
from the granulated surface of the pulmonary tissue, or 
from pulmonary apoplexy, a correct diagnosis of the case 
may be made from its previous history, together with the ra- 
tional and physical signs. The general symptoms of hae- 
moptysis are dulness, cold extremities, followed by flushes 
of heat, and red cheeks. The discharge from the lungs is 
attended with dyspnoea, pain, and oppression of the prse- 
cordia, a sense of rawness in the throat, and a sweetish 
taste in the mouth. The expectoration consists of bright, 
frothy, or black and clotted blood, sometimes mixed with 
mucus. 8&ys Laennec : " When the hemorrhage is very 
great, it comes on with a moderate degree of cough, and is 
accompanied with a convulsive elevation of the diaphragm 



HEMOPTYSIS. 151 

like that which takes place in vomiting. Auscultation fur- 
nishes us with two signs of pulmonary apoplexy, absence 
of the natural respiratory sound over a circumscribed space 
and crepitant rale around this space. 

TREATMENT. 

• 

Where this disease is dependent upon derangement of 
the catamenia, the feet should be placed in warm water, 
and hot sinapisms applied to the back and lower portions 
of the bowels, and from five to ten grains of pulverized 
matico given every fifteen or twenty minutes until the 
hemorrhage ceases. Or, put one drachm of the oil of Eri- 
geron in a pint bottle, fill it with hot water, and cause 
the patient to inhale the vapor. Either of these remedies 
will arrest the hemorrhage. Or, in the absence of other 
remedies, a teaspoonful of a strong solution of salt and 
water taken every five or ten minutes, will frequently prove 
effectual. As soon as this symptom is removed, the patient 
should be put upon a treatment as directed under the head 
of irregularities of the catamenia. Where hemorrhage 
occurs from the rupture of large vessels, ligatures should be 
applied to the legs and arms, and the patient caused to 
inhale a strong vapor of the oil of Erigeron, and at the 
same time from five to ten grains of the matico should be 
given every fifteen or twenty minutes, until it is arrested. 
During the active hemorrhage, the ligatures should be so 
adjusted as to retain the main volume of blood in the 
extremities, w 7 hich should only be allowed to return by 
degrees after the bleeding has ceased. 

As this form of haemoptysis is always connected with 
phthisis, the patient should be treated accordingly. If it 
arises from pulmonary apoplexy, the ligatures should be 
used as in the other case. A hot sinapism should also be 
applied to the chest, and the surface should be thoroughly 
bathed in hot whiskey and capsicum, for the purpose of 



152 BRONCHITIS. 

diverting the blood from the deep capillaries of the lungs 
to the superficial capillaries. Also, administer the matico 
with small doses of Lobelia and capsicum every fifteen or 
twenty minutes. The bowels should be moved by a stimu- 
lating injection, and the patient allowed to hold ice in his 
mouth. 

As soon as the hemorrhage ceases, the circulation should 
be controlled by the use of Aconite. As this form of hae- 
moptysis is connected not only with phthisis, but also with 
pneumonia and scurvy, the primary cause of the affection 
should be treated according to the nature of the case, and 
the condition of the patient. 



BRONCHITIS. 

Inflammation of the mucous membrane of the bronchi 
is one of the most common forms of pulmonary disease. It 
may be either acute or chronic. In the acute form, coryza, 
sore throat, hoarseness, and slight rigors, are the first 
symptoms. There is also lassitude with more or less pain 
in the limbs. As the disease advances there is a sensation 
of heat and soreness or rawness of the bronchial surface, 
accompanied by pain on coughing, and oppressed breath- 
ing. There is a persistent cough, with an expectoration 
of frothy mucus of a saline taste. In a more severe form 
of the disease, the small capillary tubes, as well as those 
of a medium and large size, are implicated. In this form 
of the disease the pulse is extremely frequent ; there is 
great dyspnoea, a cyanotic appearance of the countenance, 
coldness of the body, difficult respiration, and a marked 
tendency to asphyxia. In these cases the vital powers 
rapidly become exhausted, and unless relieved by timely 
treatment, delirium with fatal coma terminates the patient's 
existence. 



BRONCHITIS. 153 

Physical Signs. — In certain cases slight dulness on per- 
cussion will be detected. In protracted cases, a conside- 
rable amount of dulness may be* observed at the base of 
the lung, owing to the gravitation of the excreted fluid. 
On auscultating the chest, the respiratory murmur will be 
found weakened, and in some instances entirely sup- 
pressed. There is sonorous, sibilant, and mucous rhonchus 
in various combinations. The sonorous and sibilant 
rhonchus is most marked in the early stage of the disease ; 
the mucous in the second. But both are frequently com- 
bined in the second stage. In capillary bronchitis, in 
addition to the above signs, there is sub-crepitant rhonchus 
at both bases, posteriorly, with a fine mucous rale higher up. 
If the fine mucous rale is predominant, it most positively 
indicates inflammation of the capillary bronchial tubes. 

TREATMENT. 

The surface should be thoroughly bathed in hot lye 
water, and the patient placed in bed with a warming poul- 
tice applied over each lung. From five to ten drops of 
the Tinct. of Yeratrum Yiride should be given every half 
hour until the active symptoms of the disease disappear. 
As soon as this occurs — 

R Quinine gr. xv. 

Gelsemin gr. jss. 

Iron by Hydrogen gr. x. 

Pulverized Acacia gr. xx. 

Mix, and triturate ; divide into eight powders, and give 
one every two hours. After which, if there are any linger- 
ing symptoms, small doses of the Tinct, of Aconite 
should be given. To relieve the cough, if any should 
remain, the acetic Syrup of Sanguinaria should be used 
as indicated. The patient's strength may be maintained 
by the use of chalybeates, vegetable tonics, and a nutritious 
diet. 



154 CHRONIC BRONCHITIS. 



CHRONIC BRONCHITIS. 

This, like other forms of chronic inflammation, fre- 
quently succeeds the acute form, although it may occur in 
a slow and insidious manner, without being preceded by 
an acute form of -the disease. 

It attacks individuals of all ages ; but is most frequently 
met with in the aged, and those who are much exposed to 
the inhalation of dust. When the disease succeeds to 
acute bronchitis, the febrile symptoms disappear ; but the 
pulse still remains frequent, and the cough and difficulty 
of breathing prove persistent, although these symptoms 
are materially relieved by free expectoration. There are 
still nightly exacerbations, and irregular sleep. The ex- 
pectoration is copious, opaque, and in some instances, 
puriform. Night sweats are frequent, occasioning great 
debility. If the disease should not be relieved, the cough 
will become croupy, the expectoration more copious, the 
dyspnoea increases, there is diarrhea, and death soon 
follows. 

Physical Signs. — These are sub-crepitant, mucous, sibi- 
lant, and sonorous rales. It is said by Laennec, that we 
frequently have all the sounds in chronic bronchitis quickly 
following each other, which he calls, lt cantus omnium 
avium?' 1 (the song of all the birds). If the disease is 
mostly confined to the extreme ramifications of the bronchi, 
the sub-crepitant rale will be predominant ; if the larger 
tubes, the sibilant. If the larger tubes are the seat of the 
disease, the sonorous rale will indicate it. 

TREATMENT. 

In the early stage of chronic bronchitis : 

R Compound Syrup of Stillingia Oss. 

Iodide of Potassa , gj. 



EMPHYSEMA. 155 

Mix, and take one teaspoonful every five or six hours. A 
salt pack should be applied to the chest, and occasionally 
moistened with equal parts of the Tinct. of Iodine and 
Aconite. If there are night sweats, and periodical exa- 
cerbations : 

R Quinine gr. xx. 

Iron by Hydrogen gr. x. 

Cream of Tartar gr. xxx. 

Mix, triturate, divide into eight powders, and give one 
every four or five hours. If there is much debility, a 
liberal use should be made of porter, ale, or brandy, to- 
gether with a nutritious animal diet. Where there is much 
irritation of the upper part of the bronchi, benefit is 
sometimes derived from the use of astringent gargles. 
Also by inhaling the vapor of Aconite or Lobelia. 

If the cough is troublesome at night, a small dose of 
Lupuline, Morphine, and Prunin, may be taken at bed- 
time. When the disease assumes a tuberculous character, 
it should be treated as in phthisis. 



EMPHYSEMA. 

This term applies to air in the cellular tissue, all por- 
tions of which are liable to the affection. The sub-cu- 
taneous is the most so ; but all the prolongations of this 
tissue through the body communicate with it by the 
areolar structure. Thus the air when effused into the 
cellular tissue may pervade nearly every tissue of the body. 

There are three ways by which air may make its ingress 
into the cellular tissue. 1. By a wound of the integu- 
ment. This is termed traumatic emphysema. 2. By the 
development of gas within its cells. 3. By a fistulous 
opening through the lung, communicating with the pleural 
cavity. 



156 NEPHRITIS. 

The diagnosis of emphysema is seldom difficult. As 
when air accumulates in the cavity of the pleura, it will 
readily be distinguished from empyema, by the resonance 
on percussion. And when it accumulates in the cellular 
tissue, the swelling is uniform and light, and yields a 
peculiar crepitant sound upon pressure, caused by the 
removal of the. air from one cell to the other. 

The prognosis will depend upon the cause of the emphy- 
sema and the state of the respiratory organs. 

TREATMENT. 

In the treatment of this disease the object should be to 
arrest its progress by preventing a further accumulation of 
air in the cellular tissue, and to remove that already accu- 
mulated. In spontaneous emphysema the only effectual 
method of arresting the disease is to correct the morbid 
state of the system, which gives rise to it. When it pro- 
ceeds from asthemic and typhoid disease, Quinine and Iron 
with a liberal diet will generally arrest its progress. By 
scarification, the air which has previously accumulated, 
will make its escape. In emphysema arising from wounds, 
by enlarging the wound so as to give free exit to the air, 
the difficulty may be relieved. Where it occurs as the 
effect of a fistulous opening into the pleura, the inhalation 
of the vapor of nitrate of silver, together with astringents, 
will generally effect a cure. If there is tuberculous affec- 
tion of the lungs, it should be treated as directed under 
that head. 



NEPHRITIS, OR INFLAMMATION OP THE 
KIDNEYS. 

SYMPTOMS. 

There is an acute pain in the region of the kidneys, with 
some fever, and a dull pain in the thigh of the affected 
side= The urine is at first clear, but soon becomes of a 



CYSTITIS. 15*7 

dark red color. The patient feels great uneasiness when 
he attempts to walk or sit upright. He lies easiest on the 
affected side. The pulse is, at first, hard and full, but in 
the course of a few days, it becomes small, weak, and quick. 
The skin is hot, and the tongue covered with a dark brown 
coat. 

TREATMENT. 

Apply hot wet packs over the region of the kidneys, and 
give freely of the syrup of Marshmallow, Oliver tea, &c. 
Also, give the following compound : 

U Sweet Spirits of Nitre §j 

Tinct. of Aconite gutt. xxx. 

fjelseminuoi .... gii. 

Mix, and give fifteen drops every two or three hours as the 
case may indicate. If the disease should prove obstinate, 
a mild alterative of Euonymine should be given at bed- 
time, and Digitalis and Cream of Tartar should be substi- 
tuted for the Aconite and Gelsenihmm. The patient should 
keep quiet, and in bed, and the diet should be of a light 
vegetable character. 



CYSTITIS, OR INFLAMMATION OP THE 
BLADDER. 

Inflammation of the bladder very much resembles that 
of the kidneys in its symptoms. But there may be acute 
pain and tension at the lower part of the bowels, and diffi- 
culty of urinating, with constant inclination to do so, and 
also to go to stool. 

TREATMENT. 

The bowels should be thoroughly evacuated by Jalapin 

and Neutralizing mixture. The patient should be placed 

in bed, and hot packs should be applied over the region 

of the bladder. The bladder should be injected with a 

14 



158 HEPATITIS. 

luke-wann mucilage of slippery elm, and the patient caused 
to drink of Marshmallow, flaxseed, slippery elm, &c. If 
the inflammation is not thus controlled, give the following 
compound : 

R Pulverized Acacia gr. xx. 

Soft Water gii. 

Sweet Spirits of Nitre gss. 

Tinct. Veratrum Viride gutt. xx. 

Mix, give one half teaspoonful every half hour until the 
symptoms are controlled. Continue the mucilage until the 
patient is completely free from the disease. 



HEPATITIS, OE, INFLAMMATION OF THE 
LITER. 

SYMPTOMS. 

The diagnostic symptoms of this disease are tension of 
the right side, under the false ribs, attended with fever, 
difficulty of breathing, anorexia, thirst, and a pale and 
yellow appearance of the skin and eyes. When the inflam- 
mation is extensive, the pulse becomes quick and hard, and 
sometimes irregular. The patient is troubled with a dry, 
hacking cough, and a constipated condition of the bowels ; 
although, in the latter stage of the disease, and in warm 
climates, there is sometimes a diarrhaea with bilious vomit- 
ing, great tenderness in the hypochondrium, and dulness 
on percussion. 

TREATMENT. 

A hot sinapism should be placed over the region of the 
liver. The surface should be bathed in warm lye water, 
and the following compound be given : 

U Euonymin gr. xx. 

Sanguinarin gr. x. 

Bitartrate of Potassa gr. xxx. 



ASTHMA. 159 

Triturate, mix ; divide into ten powders, and give one 
every three hours. At the same time, if there is fever, give 
from ten to twenty drops of the Tinct. of Gelseminum so 
often as to maintain a gentle moisture of the skin. 

When the sinapism has produced irritation of the sur- 
face, it should be removed and hot packs applied instead. 
If the disease should still prove persistent, the following 
compound must be substituted for the first : 

U Muriate of Ammonia gr. xx. 

Irisin gr. x. 

Gelsemin gr. j. 

Triturate, mix, divide into ten powders, and give one every 
two hours until all are taken, or until the disease is re- 
moved. If the disease should assume a chronic form, a 
pill of the extract of Dandelion and Capsicum should be 
given two or three times a day. If the bowels should 
become constipated from a deficient secretion of bile, give 
the following compound : 

U Syrup of Boneset Oss. 

Common Salt gi. 

Sulphur gr. xxx. 

Mix, and give one teaspoonful three times a day, and let 
the diet be free and nutritious. 



ASTHMA. 

SYMPTOMS. * 

The symptoms indicating asthma are various. Some 
of them are premonitory, and, by those who are accustomed 
to the affection, are understood as warnings of an ap- 
proaching attack. Among these are loss of appetite, 
flatulence, eructation, languor, irritability, drowsiness, 
oppression and chilliness. Perhaps he retires at night 
with a sense of uncomfortableness. 
* Calkins. 



160 ASTHMA. 

It is very common for an attack actually to commence 
sometime after midnight, or about 2 or 3 o'clock in the 
morning, and the general signs are much like the follow- 
ing : 

Often the person is aroused from sleep by a feeling of 
constriction. across his chest, or inability properly to ex- 
pand it. He raises himself in bed, and sits bowing for- 
ward, perhaps with his elbows resting on his knees, drawn 
up before him. His breathing is labored, and attended 
with a wheezing noise, often so loud as to be audible in 
another apartment, or at a distance. 

He asks for more air to be admitted into the room, and 
makes a strong voluntary effort to expand his chest in 
inspiration, and to contract it in expiration ; or, if able, 
he rises from his bed, and hastens to a door or window, at 
which, however cold the weather, he often long remains. 
The labor of respiration gives warmth to his body, and he 
often perspires freely. His extremities, however, are 
liable to become cold, and his countenance is generally 
distressed, pale and haggard, though sometimes it is red 
and turgid. Often the pulse is small, feeble and irregular, 
though sometimes it is scarcely disturbed. Sometimes the 
heart palpitates, and flatulency becomes troublesome ; the 
urine becomes copious and pale, and even the fasces are 
passed with the impatient hurry of spasmodic action. The 
speech of the sufferer is interrupted and difficult, and there 
is a propensity to cough, which he sometimes favors with 
the hope of forcing away the impediment to his breathing.* 

TREATMENT. 

In the treatment of this disease, the first thing to be 
attained is the relief of the excessive dyspnoea. For this 
purpose, give the following mixture : 

* Calkins on Thoracic Diseases. 



CHOLERA MORBUS. 161 

R Tinct. of Gelseminum < ... gj. 

" Lobelia... gss. 

Mix, and give fifteen or twenty drops every ten or fifteen 
minutes, till the paroxysm passes off. After which, give 
the following compound : 

R Quinine gij. 

Cornine . ^iij. 

Compound Syrup of Stillingia Oj. 

Phosphate of Lime gj. 

Mix, and give from one half to one teaspoouful three times 
a day, during the interval between the paroxysms of 
dyspnoea. Whenever the paroxysms return, the Gelsemi- 
num and Lobelia should be repeated. But as soon as 
relief is obtained, the alterative and antiperiodic should be 
resumed. Other medicines, such as Chalybeates and vege- 
table tonics, if required to maintain the integrity of the 
constitution, should be given. The above course, if per- 
sisted in, will seldom fail to remove this very troublesome 
disease. 



CHOLERA MORBUS. 

Cholera Morbus is a violent purging and vomiting, with 
griping, sickness, and a constant desire to go to stool. 

It is occasioned by a redundancy of bile, by the fermen- 
tation of food on the stomach, such as cucumbers, melons, 
sweet-meats, cherries, and all unripe fruit. Also exposure 
to damp night atmosphere. 

SYMPTOMS. 

It is generally preceded by Cardialgia, sour stomach, 
flatulency, and pain in the bowels. As the disease 
advances, the pulse becomes very feeble, and the surface 
cold and clammy. The urine is scanty, and there is almost 
constant vomiting and purging. 
1-4* 



162 CHOLERA. 



TREATMENT. 

JJ Neutralizing Mixture §ij. 

Tinct. of Prickly Ash Berries gj. 

Mix, and give from 30 to 60 drops every fifteen or twenty 
minutes, till the vomiting and purging cease. Apply a 
hot sinapism over the region of the stomach and bowels, 
and place jugs of hot water about the patient. If the use 
of the above mixture for a proper time does not afford relief, 
give the following : 

U Pulverized Camphor gr. x. 

" Capsicum gr. xv. 

Oil of Peppermint gutt, iij. 

Morphine gr. j. 

Triturate, mix, divide into ten powders, and give one 
every half hour. At the same time, give the patient freely 
of rice coffee, made by scorching the rice and preparing it as 
common coffee. If the. disease assumes a periodic charac- 
ter, some of the antiperiodic compounds should be given 
for the purpose of interrupting its periodicity. After the 
vomiting and purging cease, mild alteratives should be 
given, as Euonymine, Hydrastin, &c. The diet should 
consist of rice, dropped eggs, broiled beef, &c. The 
patient should avoid exposure to the sun, and violent 
exercise, until completely recovered. 



CHOLERA, EPIDEMIC OR CHOLERA 
ASPHYXIA. 

This disease began to excite general attention in 1811. 
It commenced in Bengal in India, from which place it has 
scarcely been absent since. In 1818 it passed on to the 
Coromandel coast, and in the same year to Malabar, the 
Burmese Empire, Sumatra and Ceylon. In 1820 it spread 



CHOLERA. 163 

to China, and successively throughout the larger portion 
of Eastern Asia, and to the islands of the Mediterranean, 
to Arabia, Mesopotamia and Syria. In 1821 and in 1822 
to Persia. In 1831 it appeared in Prussia and in Austria. 
In June of the same year it appeared in St. Petersburg, 
in October at Hamburg and London. On the eighth of 
June, 1832, it first made its appearance on the American 
Continent in Quebec, and in a few days at Montreal. On 
the 24th of June in New York, on the 3d of July in 
Albany, on the 5th of July in Philadelphia, on the 30th of 
September in Cincinnati, from whence it spread to Madi- 
son, Louisville, St. Louis, Maysville, Wheeling, and made 
its way to most of the important towns in the United 
States. 

It reappeared in America in 1848, where it has pre- 
vailed as an epidemic or in a sporadic form ever since. 
Its fearful ravages and well-known fatality, have elicited 
on the part of the medical profession, the most anxious 
inquiries, in regard to its cause and pathology. 

SYMPTOMS. 

Malignant cholera, like most other epidemic diseases, 
presents a great diversity of symptoms. Its attack is 
usually violent and sudden, but mostly preceded by certain 
premonitory symptoms, such as a furred tongue, diarrhea, 
with a complete loss of the digestive powers, and some- 
times with headache and ringing in the ears. After these 
symptoms have continued for a longer or shorter time, 
the patient is attacked with violent Cardialgia or heart- 
burn, soon followed by nausea and vomiting, with a pro- 
fuse colliquative diarrhsea. The discharges from the 
stomach and bowels resemble rice water. These symp- 
toms are soon followed by great weakness and sense of 
exhaustion. 

The powers of locomotion are speedily arrested, and 



1G4 CHOLERA. 

spasms affecting the whole of the muscles of voluntary 
motion, but particularly those of the arms and legs, come 
on. The pulse becomes small, weak, and accelerated, the 
respiration labored, the tongue flat, white, and moist. 
These symptoms are soon followed by a sense of pain, and 
burning heat in the stomach, and great desire for cold 
drinks. The skin becomes cold, corrugated, and covered 
with a clammy sweat. The lips, limbs, and at times the 
entire body, have a peculiar livid hue. 

The pulse decreases until it is no longer felt at the 
wrist, the respiration is slow and feeble, the breath is cold, 
the eyes are sunken, and surrounded by a livid circle. At 
this stage there is no secretion of the bile and urine, and 
the vomiting, purging, and spasms abate. The powers 
of the mind seem unimpaired, for the patient continues to 
answer questions freely ; but he frequently expires in this 
stage suddenly and without a straggle. 

The limits of this work will not permit me to enter into 
the details of the different varieties of this disease ; but 
suffice it to say, it often runs an entire course to a fatal 
termination, without vomiting or cramp, but characterized 
by the peculiar diarrhea. Again the diarrhgea may be 
absent, and the vomiting be the principal symptom, The 
rice water evacuations, together with the excessive pros- 
tration, are sufficient to distinguish it from cholera morbus. 

TREATMENT. 

The indications to be fulfilled in the treatment of 
Cholera, are to arrest the diarrhaea and vomiting, and to 
produce reaction, or to equalize the circulation, by 
inducing the blood from the deep-seated, to the superficial 
capillary vessels. For the purpose of arresting the 
vomiting and diarrhoea, small doses of Camphor, Capsi- 
cum, and Morphine, should be given every ten or fifteen 
minutes, in a small quantity of Neutralizing Mixture : say, 



CHOLERA. 165 

R Pulv. Camphor , gr. v. 

Capsicum .... gr. x. 

Morphine gr. j. 

Triturate, mix, divide into ten powders, and give one 
every fifteen or twenty minutes in one half to one tea- 
spoonful of Neutralizing Mixture, until the nausea and 
vomiting cease. At the same time the patient should be 
placed in bed in a recumbent posture, which should be 
maintained during the entire active stage of the disease. 
Tire body should be thoroughly bathed in equal parts of 
lye water, and Tinct. of Capsicum. Also apply sinapisms 
along the spine, calves of the legs, abdomen and arms. 
They should be applied hot, made up of good ground 
mustard, and wet with hot vinegar. If there is thirst, 
hot rice coffee should be freely given. Also toast water 
and ftsence of beef, prepared as directed in the treatment 
of typhoid fever. If the nausea., vomiting, and diarrhoea, 
do not yield to the above treatment, the following com- 
pound may be given : 

R Tinct. of Prickly Ash Berries giij. 

Neutralizing Mixture giij. 

Tinct. of Capsicum giij. 

Mix, and give one teaspoonful in hot peppermint sling 
every five or ten minutes. Also inject the bowels with the 
following mixture : 

R Starch Water Oss. 

Tinct. of Xanthoxylin Berries gij. 

Morphine giij. 

Mix, and give six ounces as an injection after each pas- 
sage from the bowels. If reaction, should not follow 
these measures, hot brandy toddy may be given in con- 
nection with them every half hour. If there should be 
cramp with the vomiting and diarrhaea : 



166 CHOLERA. 

R Gelsemin , gr. ij. 

Hyosciamin gr. j. 

Pulv. Camphor , ... gr. ij. 

White Sugar gr. xxx. 

Triturate, mix, divide into ten powders, and give one 
every half hour, or oftener, as the case seems to indicate. 

If the discharges continue, and the patient be pros- 
trated, the following compound will often be successful : 

U Rhusin * gr. xij. 

Quinine gr. x. 

Piperine gr. xx. 

Hydrocyanic acid gutt. iij. 

White Sugar -. gr. xxx. 

Mix, triturate, divide into twenty powders, and give one 
every thirty minutes. If the sinapisms produce too strong 
counter-irritation, they should be taken off, and lar^ hot 
packs applied in their place. If the reaction should be 
followed by fever, Aconite should be given in quantities 
sufficient to control the circulation, and maintain mois- 
ture of the surface. 

Where the patient has passed into the collapsed state, 
the following compound is valuable : 

U Xanthoxylin gr. xx. 

Piperine gr. x. 

Oil of Capsicum gutt. x. 

White Sugar gr. xxx. 

Mix, divide into ten powders, and give as often as the 
symptoms indicate the necessity. 

Shocks of electricity, passed through the stomach and 
liver, have been reputed of much value. Also highly 
stimulating diuretics, such as oil of Turpentine, Hemlock, 
Wintergreen, &c. 

The following compound was used with much success 
by my colleague, the late Dr. Hotchkiss : 



SMALL-POX. 167 

R Chloroform £ii. 

Tinct. of Camphor gii. 

Tinct. of Opium ^i. 

Mix, and give from ten to twenty drops every twenty or 
thirty minutes, as the case may be. As soon as the active 
stage has passed off, the patient should take freely of fluid 
nutriment containing the elements of the blood, for the 
purpose of restoring its exhausted condition. Also, he 
should remain quiet and in bed, and avoid both mental 
and physical exertions. 

SMALL-POX, OR VARIOLA. 

SYMPTOMS. 

The premonitory symptoms of this disease do not vary 
much from those of ordinary bilious fever. 

It is generally preceded by -more or less languor, ano- 
rexia, headache, and constipation of the bowels. When 
these symptoms have continued for two or three days, the 
patient is seized with violent pain in the back, increased 
pain in the head and limbs, great restlessness ; the pulse 
becomes accelerated, and the skin is hot and pungent. 
The eyes are suffused, and in some cases the fever is alter- 
nated with rigors or chills. On the fourth or fifth day of 
the disease, small red spots make their appearance on the 
face and neck, which gradually diffuse themselves over the 
entire body. 

The eruption is at first pustular, but in the course of 
eight or ten days becomes vesicular at the apex, yet still 
remaining pustular at the base. The vesicular portion of 
the pustule has a cupped appearance, while the base re- 
mains white and opaque. Maturation commences from 
the tenth to the fifteenth day, at which time the pustules 
become covered with a mahogany-colored scab, terminat- 
ing in desiccation and desquamation, and leaving a deep 



168 SMALL-POX. 

pit. At this stage the patient generally has a fresh attack 
of fever, called the secondary fever. When the pustules 
are very numerous, and run into each other, the disease is 
called confluent small-pox. This is decidedly more violent 
than the simple form. 

There is extensive oedema of the face and lower extremi- 
ties, and inflammation of the fauces, lungs, and in some 
instances, the brain ; and the disease not unfrequently 
terminates in consumption, blindness, and ulceration of the 
intestines. 

TREATMENT. 

In the treatment of small-pox, much diversity of opinion 
exists among eclectic physicians ; but the treatment about 
to be described has not only proved universally successful 
in my own practice, but in that of several of my colleagues, 
who have had the most ample experience in this disease. 

If called in the early stage, the first thing to be done is 
to give the patient an active cathartic of Podophyllin and 
Antibilious physic. The patient should then take a 
thorough spirit-sweat, after which the body should be tho- 
roughly bathed in hot lye water, and the patient placed in 
bed, in a room well ventilated. The following compound 
should then be given : 

U Bay berry Bark, Pulv. , gss. 

Ginger, Pulv gj. 

Macrotys, Pulv gij. 

Capsicum ^j. 

Mix, put it in one quart of water, steep for fifteen or 
twenty minutes, strain, sweeten, and give two or three 
tablespoonfuls every hour during the development of the 
disease. If there is fever, give Aconite to control it, and 
small doses of diaphoretic powders at night to procure 
rest, if necessary. The surface should be bathed in lye 
water and whiskey three or four times a day. 
If the pustules should not fill well, and the strength of 



MEASLES. 169 

the patient should fail, small doses of equal parts of Hy- 
drastin and Quinine should be given three or four times a 
day. Also, give milk punch, beef tea, and such other 
articles of diet as are easy of digestion and nutritious. 
Collodion should be applied as a wash morning and even- 
ing, to prevent being marked by the eruption. If the dis- 
ease be of the complicated variety, the constitutional symp- 
toms will require more attention. 

If the lungs become affected either by congestion cr in- 
flammation, they should be relieved by Lobelia and Capsi- 
cum. If the liver is thus diseased, Euonymine and Lep- 
tandrin may be used. If the glands of the bowels should 
become diseased, Hydrastin and the Nitrate of Silver pill 
as directed under the head of Typhoid Fever, should be 
given. 

The fever should be controlled as in the simple form, and 
the patient's strength maintained by the use of beef tea, 
wine, porter, vegetable tonics, Chalybeates, &c. 



RUBEOLA, OR MEASLES.* 

In our humble opinion, this is both a contagious and 
infectious disease, affecting, in this climate, children and 
adults with almost equal severity; the disease is inflam- 
matory, affecting at once the skin and gastro-pulmonary 
mucous membrane ; in which, after catarrhal fever has 
continued about three days, a rash appears on the skin, at 
first in small stigmatized dots, not unlike flea-bites, which 
presently coalescing, form patches of a crescent or semi- 
lunar form ; first on the face, and thence spreading gradu- 
ally downwards over the whole body and limbs, at the end 
of four days they disappear by desquamation of the 
cuticle. In short, the symptoms which usher in an attack 
of measles, are the symptoms of coryza and catarrh.* 

* Massie's Practice of Medicine. 
15 



HO MEASLES. 



TREATMENT. 

Iii the great majority of cases, but little treatment is 
necessary, save to have the patient confined to the house, 
which should be kept of an agreeable temperature, and 
freely ventilated. The clothing should be changed daily, 
and the bowels kept regular by small doses of Neutralizing 
Mixture and Leptanclrin. 

Should symptoms of Pneumonia, Bronchitis, or Laryn- 
gitis make their appearance, an emetic of Lobelia and 
Sanguinaria should be administered, together with the 
warm bath and laxative enema. As soon as the effects of 
the emetic have passed off, the following compound should 
be given, if a child over eight years of age ; if younger, 
in proportion to the age : 

U Triturated Belladonna gr. x. 

Sulphate of Cinchonin gr. xx. 

Triturated' Leptandnn , gr. xx. 

Mix, divide into ten powders, and give one every two 
hours ; also give freely of warm sage tea. 

If there should be fever, and pain in the head, five 
drops of Aconite, added to three ounces of water, and a 
teaspoonful given every half hour, will soon control it. 

If, as sometimes happens, the patient should be seized 
with convulsions, small doses of equal parts of Lobelin 
and Scutellarin, given every ten or fifteen minutes, will 
relieve them. 

The surface should be frequently sponged, and if there 
is heat in the head, moderately cold packs should be ap- 
plied and continued until the head is relieved. 

The diet should be light, and taken in small quantities. 
If Ophthalmia makes its appearance during the disease or 
afterwards, mild zinc ointment should be used, and the 
eves should be frequently bathed in warm milk and water. 



CHICKEN-POX — MANIA-POTU. 171 



VARICELLA, OR CHICKEN-POX. 

This is a contagious disease, and in its first appearance, 
bears some resemblance to small-pox. 

SYMPTOMS. 

Small, pointed, transparent red vesicles, some of which 
become pustular. They run their course in from five to 
six days, without producing any very marked constitu- 
tional disturbance. 

TREATMENT. 

The diet should be regulated, and regularity of the 
bowels maintained. If fever arises, give Aconite in small 
quantities, and a gentle purgative of Euonymine and 
neutralizing; mixture. 



MANIA-POTU, OR DELIRIUM 
TREMENS. 

This disease in some of its symptoms, resembles inflam- 
mation of the brain. It is caused by the use of Alcoholic 
drinks. 

SYMPTOMS. 

Constant wakefulness, and motion of the hands and 
arms, and continual delirious talk. The whole body is in 
a state of tremor, wrongs are imagined, injuries appre- 
hended, and the patient constantly beholds imaginary 
images, which terrify his mind, producing great mental 
excitement. This disease is easily distinguished from 
Pleuritis, by the softness of the pulse, the flushed face, 
and the habits of the patient. 



13 



172 DROPSY OF THE BRAIN. 

TREATMENT. 

In this disease it is necessary to continue the use of 
stimulants, in a moderate degree. The patient should 
take warm whiskey toddy, mixed with starch water, often 
enough to maintain a decided influence of the spirits upon 
"the brain. At the same time give freely of beef tea, wine 
whey, soft boiled eggs, &c. If the disease does not yield 
to the above treatment, give the following compound : 

R Morphine gr. ij. 

Capsicum gr. xx. 

Divide into ten powders, and give one every two or three 
hours till the disease yields. 

Or, 

U Scutellarin gr. xx. 

Hyosciamin gr. iij. 

Cypripedin gr. xx. 

Triturate, mix, divide into ten powders, and give one 
every hour. When the disease becomes manageable, the 
use of alcoholic drinks should be discontinued, and the 
patient warned against the use of a drug, the effects of 
which are fraught with so much evil. During the treat- 
ment, the bowels should be kept regular, by the use of 
mild stimulating alteratives, and the skin thoroughly 
cleansed by bathing. 



HYDROCEPHALUS, OR DROPSY OF 
THE BRAIN. 



SYMPTOMS. 



When the disease comes on moderately, the patient 
becomes peevish and fretful. If it is a child, which is 
most frequently the case, there will be frequent extension 
of the hands to the head, and the sleep will be disturbed 



DROPSY OF THE BRAIN. 173 

by frightful dreams, causing starting, jumping, and 
screams. 

As the disease advances, there is anorexia, dizziness, 
vertigo, nausea, vomiting, and delirium. 

The pulse is soft and quick, and the tongue is covered 
with a light coat. In the early stage of the disease, the 
bowels are costive ; but in the latter stage, there is fre- 
quently diarrhsea. Paralysis and convulsions often result 
from this disease. 

TREATMENT. 

In the early stage of this disease, Aconite should be 
given to control the fever and inflammation. After which, 
a purgative of Podophyllin and Jalapin should be given. 
Warm water and whiskey should be applied to the head, 
and sinapisms to the feet and calves of the legs. After 
the operation of the cathartic, give the following com- 
pound : 

B Syrup of Marshmallow §iij. 

Iodide of Potassium ^ij. 

Mix, and give one half teaspoonful every hour. At the 
same time, give two or three tablespoonfuls of strong 
Buchu and uva ursi tea, and ten drops of sweet-spirits of 
Njtre every three hours. If there is much debility, con- 
nected with periodical symptoms, the following compound 
may be given, with the above treatment : 

B Quinine gr. x. 

Ferrocyanide of Potassium gr. j. 

Digitalin gr. j. , 

White Sugar gr. xl. 

Triturate, mix ; divide into twelve powders, and give one 
every three hours. The purgative should be repeated, and 
the strength of the patient maintained by the free use of 
Iron, vegetable tonics, and a nutritious diet. 
15* 



1T4 DROPSY OF THE ABDOMEN. 

ASCITES, OR DROPSY OF THE ABDOMEN. 

SYMPTOMS. 

Swelling of the bowels, and often a fluctuation which 
may be perceived by laying the hand on one side of the 
abdomen, and at the same time gently rubbing the other 
side. This disease is mostly connected with Anasarca, or 
a collection of water in the cellular tissue, indicated at 
first by swelling of the feet and ankles towards night, but 
which disappear before morning. Pressure of the swollen 
parts with the finger in the evening, produces indentation, 
which remains for some time. The swelling gradually 
ascends to the trunk of the body, the arms and the head. 

At this time the breathing becomes difficult, the urine is 
scanty and high-colored, the bowels are costive, the 
countenance is heavy and bloated, the skin is dry, and has 
a dirty sallow appearance, there is a dry cough and a slow 
irregular fever. 

When these symptoms have continued for a longer or 
shorter time, there is generally a deposition of tuber- 
culous matter in the lungs, a hectic fever, and unless the 
progress of the disease is arrested by timely treatment, 
death is the result. The use of Mercurials, the suppression 
of the Catamenia, Chronic ague, improper diet, &c, are 
among the causes of this disease. 

TREATMENT. 

The first object should be to remove the cause. At the 
same time, means should be resorted to by which the blood 
may be restored to a natural condition, and at the same 
time relieve the different tissues from their incumbrance of 
water. The patient should be placed upon a strong 
nutritious diet, and should freely use beef tea, porter, &c, 
and should take the following compound : 



31 U MPS. 175 

U Iron by Hydrogen gr. xx. 

Syrup of dwarf Elder Oss. % 

Cream of Tartar -ss. 

Mix, and give one tablespoonful three or four times a clay. 
Two or three times a week the patient should take a 
thorough spirit-sweat, and the body should be sponged 
every morning in warm or cold water, as the condition of 
the case may indicate. 

If the patient's strength will warrant, a cathartic of 
Jalapin and Cream of Tartar may be given once or twice a 
week. "When the above course has been pursued for a few 
days, if the patient does not manifest signs of rapid re- 
covery, give the following compound : 

R Digitalin gr. iij. 

Cinchonine gr. xxx. 

Phosphate of Iron gr. xxx. 

"White Sugar ;. -j. 

Mix, triturate ; divide into sixteen powders, and give one 
four times a day in watermelon seed tea. 

After these are all taken, the syrup should be resumed, 
and the vapor bath continued. 

Every possible means should be resorted to by which 
the patient's strength may be maintained. 



PAROTITIS, OR MUMPS. 

This is a contagious disease, affecting the Parotid gland. 

SYMPTOMS. 

The skin becomes hot and dry, the pulse increases in 
frequency. The tongue is covered with a thin white coat, 
the bowels are costive, and the urine is scanty and high- 
colored. These symptoms are followed by a swelling just 



116 EPILEPSY. 

below the angle of the lower jaw, sometimes on one side, 
at others* on both. The swelling increases rapidly for 
about two days, when it begins to decline. 

This disease is frequently transferred from the glands of 
the neck to the mammary glands, in the female, and to 
the testicles of the male. 

TREATMENT. 

If there is much fever in the active stage, the body 
should be bathed in warm lye water, and Aconite given in 
quantities sufficient to subdue it. The patient should keep 
quiet, and in bed. If the bowels are confined, a mild dose 
of Antibilious Physic may be given. If there should be a 
metastasis of the disease, a stimulating liniment should be 
applied, such as Tinct. of Capsicum and Myrrh, and a 
mild alterative of Euonymine given two or three times a 
day. 



EPILEPSY. 

SYMPTOMS. 

The patient falls suddenly, and is seized with convul- 
sions. The features are distorted and fixed, the senses are 
suspended, and the subject paralyzed. During the struggle, 
mucus, commingled with bubbles of air, issues from the 
mouth. The breathing is generally hurried, and the pulse 
is feeble and frequent. These attacks return at stated 
periods, and generally increase in severity as the patient 
grows older. The disease is frequently developed by irri- 
tation from teething, worms, suppression of the menses, 
blows upon the head, spermatorrhea, &c. 



EPILEPSY. 117 

TREATMENT. 

In the early stage of the disease, but little need be done 
save to remove the cause. But after the disease has become 
established, the convulsions will continue, although the 
cause be removed. 

In such cases the intermittent and antiperiodic treatment- 
is that only which has proved successful in my hands. 
While the patient is laboring under the paroxysms, the 
following mixture should be given : 

B Fluid Extract of Scutellaria, \ 

" " of Lobelia, > ad libitum. 

" •' of Cypripedrin, J 

Equal parts. Mix, and give from ten to twenty drops 
every ten or twenty minutes, until the convulsions cease. 
Then open the bowels by a mild, neutralizing physic, and 
the skin by tepid baths, after which give the following 
compound : 

U Chinoidin gr. xxx. 

Fiburine gr. xx. 

Quinine . gr. x. 

Mix, divide into twenty powders, and give one three times 
a-day. Continue the powders between the first four or five 
paroxysms, and relieve the patient during the paroxysms 
by the anti-spasmodic mixtures, followed by the cathartic, 
If the above treatment does not interrupt the paroxysms 
in the course of eight or ten weeks, the following mixture 
may be given between the spasms : 

R Port Wine Oss. 

Hydrocyanic acid gutt. xx, 

Quinine gr. xx. 

Iron by Hydrogen gr. xxx. 

Mix, and give one teaspoonful three times a-day. The 
patient's bowels should be opened by mild purgatives, 
The mind should be kept cheerful, and the diet should be 
nutritious, and of easy digestion. The antiperiodic and 



1?8 APOPLEXY. 

intermittent treatment should be pursued until a cure is 
effected, which will be the case in the course of time, unless 
there is some organic lesion of the brain. 



APOPLEXY. 

Sanguineous Apoplexy is the effusion of blood into the 
substances of the brain. Traumatic, or Apoplexy caused 
by blows on the head, is the effusion of blood into the mem- 
branes of the brain. 

SYMPTOMS. 

Apoplexy is generally preceded by giddiness, pain and 
swimming in the head, ringing in the ears, and laborious 
respiration. In Sanguineous apoplexy, if the person does 
not drop dead at once, he gradually becomes stupid, until 
he passes into a profound sleep ; the face is swollen, the 
eyes are fixed, the blood-vessels about the neck beat rapidly 
and forcibly, the breathing is sonorous, and it is impossible 
to arouse the patient from his state of lethargy. 

TREATMENT. 

Ligatures should be placed around the arms close to the 
shoulder ; also, around the legs at their connection with 
the body. They should be so adjusted as to admit of the 
passage of the blood through the arteries, but to prevent 
its return through the veins. 

If the patient can swallow, a large dose of antibilious 
physic should be given. The feet should be placed in hot 
w T ater, and cold water applied to the head. If the circula- 
tion continues to be rapid, Veratrum should be given in 
quantities sufficient to moderate its action. 

The ligatures should be kept on until the patient appears 
entirely relieved, but should be tightened or loosened 
according to circumstances. If symptoms indicate hemor- 



CHOREA — PALSY. 1^9 

rhage to any considerable extent, small closes of Digitalin 
should be given three or four times a day, in connection 
with Iodide of Potassium. The bowels should be kept 
regular, and the diet mild. 



CHOREA, OR ST. TITUS 7 DANCE. 

SYMPTOMS. 

There is a lameness of one leg, which is partly deprived 
of its natural motion. The arms are next affected, and 
are thrown into various contortions. The muscles of one 
side of the face have a constant involuntary motion. The 
appetite is lost, and the bowels become irregular. 

TREATMENT. 

R Scutellaria gr. xxx. 

Cypripedin gr. xx. 

Carbonate of Iron gij. 

Port Wine Oj. 

Give one tablespoonful three times a clay. The bowels 
should be kept open with small doses of Euonymine, and 
the surface should be bathed with tepid water every morn- 
ing. If the disease should be caused by suppression of 
the menses, Macrotin should be given in connection with 
Iron. If by worms, Santonine and Podophyllm. If by 
ague, some of the antiperiodic compounds may be given. 



PARALYSIS, OR PALSY. 

If the palsy is confined to one side of the body, it is 
called Hemiphlegia. If to the lower half, Paraphlegia. 

TKEATMEXT. 

TThen the palsy attacks the heart, lungs, or any other 
vital organ, it soon terminates in death. But when it 



180 PALSY. 

arises from injuries of the spine, effusions into or softening 
of the brain, or in a deficiency of nervous fluid, the follow- 
ing treatment may he resorted to with hopes of success. 
First. The patient should be enjoined to remain quiet in 
bed, and if an injury to the spine is the cause of the dis- 
ease, the irritating plaster should be applied along the 
spine. The bowels should be acted upon by giving small 
doses of antibilious physic, and a mild current of electricity 
should be passed from above the part of the injury through 
the paralyzed parts. The diet should be sufficient to 
maintain an ordinary degree of health. A liniment should 
be applied to the palsied part, composed of the following 
substances : 

U Oil of Origanum gij. 

" Capsicum gj. 

" Stillingia gfjjj. 

" Alcohol Oj. 

Mix, and bathe the affected part three or four times a day, 
following the same by brisk friction. The patient should 
take from one to three drops of the Tinct. of Rhus Toxico- 
dendron from one to three times a day. If the disease 
occurs from injuries of other parts of the body, a similar 
course should be pursued, both as regards the electricity 
and counter-irritation. If there should be softening of the 
nervous centres, or brain, from one to five drops of the 
Tinct. of Phosphorus should be given three or four times 
a day, in connection with chalybeates and vegetable 
tonics. 

This course should be persisted in for some length of 
time, unless the disease yields. In quite a number of cases 
with which I have been familiar, recovery has taken place 
after a lapse of more than a year's treatment. 



LOCKED JAW — HYDROPHOBIA. 181 



TETANUS, OR LOCKED JAW. 

This disease generally arises from wounds, but occa- 
sionally it is a symptom of other diseases. 

SYMPTOMS. 

Stiffness in the back of the neck, difficulty of swallow- 
ing, rigidity of the muscles of the lower jaw, also of those 
of the spine, and sometimes nearly all the muscles of 
the body are involved. 

TREATMENT. 

If this disease is caused by a wound, it should be tho- 
roughly burnt with caustic, and a poultice applied until a 
complete discharge is produced. At the same time the 
patient should take a lobelia emetic, followed by Euony- 
mine and Jalapin, until it operates as an active cathartic. 
After wilich, give the following compound : 

Jfc Dioscorine gr. xx. 

Scutellaria gr, xxx. 

Quinine gr. xx. 

Mix, divide into ten powders, and give one every two 
hours until all are taken. If the disease is not removed, 
the Lobelia emetic should be repeated, and again followed 
by the powders. The skin should be kept cleansed by lye 
water baths, and a free diet allowed. 

The above treatment has proved triumphantly successful 
in my hands in several w^ell-marked cases of this disease. 



HYDROPHOBIA. 

This disease is caused by the bite of rabid animals. 
The wound generally heals rapidly, and it is not until 
16 



182 DIABETES. 

twenty or thirty days have elapsed that any pain is felt in 
the wound. 

SYMPTOMS. 

Anxiety, restlessness, nervousness, loss of sleep, horror 
of water, and finally convulsive spasms, are the prominent 
symptoms of the affection. 

TREATMENT 

In the treatment of this disease, much depends upon 
thoroughness and perseverance. The wound should be 
canterized with caustic Potassa, and caused to discharge 
freely for five or six weeks. The patient should take an 
active Lobelia emetic, followed by a brisk Podophyllin 
cathartic, and a spirit .sweat. After which, the following 
compound should be given : 

R Scutellarin gr. xx. 

Cypripedin , gr. xx. 

Lobelin gr. v. 

Quinine gr. xxx. 

Mix, divide into ten powders, and give one every two 
hours until all are taken. At the same time, a strong 
decoction of Plantain should be drunk freely during the 
day. Lupulin and Hyosciamin should be given at bed- 
time, to produce sleep. The emetic and other remedies 
should be continued until the patient is entirely relieved 
from the disease. 

This treatment has proved successful in the hands of 
several eclectic physicians. 



DIABETES, OR SACCHARINE URINE. 

This disease has its primary cause in the stomach. 



DIABETES. 183 



SY3IPT0MS. 

It is generally preceded by debility, anorexia, dry skin, 
pain in the lumbar region, and great thirst, with alternate 
attacks of chills and fever. On examining the urine, it is 
found to have a sweetish taste and smell. 

TREATMENT. 

Give one grain of Aletrine in a tablespoonful of brandy 
toddy three times a day, and keep the surface freely 
bathed in warm broke water and whiskey. 

In the early stage of the disease, this treatment, if per- 
sisted in for three or four weeks, will generally effect a 
cure. But in the more advanced stage, where the kidneys 
have become organically affected, the irritating plaster 
should be applied over that region, and the following 
compound given : 

U Xantkoxylin gr. x. 

Populin gr. x. 

Prunin gr. x. 

Sach. Alba gr. xxv. 

Mix, divide into twelve powders, and give one every three 
hours. After which, give the following : 

U Syrup of Sugar gij. 

Tinct. of Capsicum gij. 

Muriated Tinct. of Iron gj. 

Mix, and give one teaspoonful three times a day. If there 
are intermittent symptoms, some of the antiperiodic com- 
pounds should be given, followed by bitters made of 
Brandy and Aletris Farinosa. 

The bowels should be kept regular, and the stomach 
evacuated with Sanguinarin, and Lobelia if indicated. 



184 RHEUMATISM. 



RHEUMATISM. 

Acute rheumatism commences with weariness, shivering, 
quick pulse, restlessness, thirst, and fever. The patient 
soon complains of pains in some of the joints, which in- 
crease by motion. The parts swell, and have a red and 
inflamed appearance, the tongue is covered with a heavy 
white coat, the bowels are costive, the urine scanty and 
high-colored. 

TREATMENT. 

R Podophyllin gr. ij. 

Xanthoxylin gr. iij. 

White Sugar gr. xxx. 

Mix, triturate, and divide into eight powders. Give one 
every hour until it operates as a cathartic. After which, 
give the following compound : 

R Sanguinarin < gr, ij. 

Iridin gr. j. 

Quinine gr. x. 

Mix, divide into ten powders, and give one every three 
hours. The body should be thoroughly bathed in strong 
salt and water, and the inflamed joints packed with hot 
cloths. If the disease does not yield, a pill may be given 
composed of the following materials : 

R Ext. Hyosciamus gr. ij. 

Ext. Indian Hemp gr. xx. 

Capsicum gr. x. 

Mix, form a mass, and make three-grain pills. Give one 
every three or four hours. If there is fever, Aconite or 
Veratrin should be given to control it. If the rheuma- 
tism is of a chronic character, give the following : 

R White Pine Turpentine gr. xxx. 

Extract of Poke Root gr. x. 

Macrotin gr. v. 

Apocynin gr. x. 



croup. 185 

Mix, form a mass, and make three-grain pills. Give one 
every five hours. Animal broths should be taken freely 
as a diet. The kidneys should be stimulated by mucila- 
ginous diuretics, and stimulating liniments should be 
applied to the affected limbs. 

Much care should be taken not to induce metastasis to 
the heart ; but if that should occur, Aconite, compound 
syrup of Stillingia, and Iodide of Potassium are the 
remedies. 



TRACHEITIS, (CROUP, OR INFLAM- 
MATION OF THE TRACHEA.) 

This disease is divided into two varieties, the spasmodic 
and pseudo-membranous. In the spasmodic form, there is 
a sudden contraction of the Trachea, owing to a slight 
cold, or the transmission of irritation to that organ from 
the stomach and gums in teething. The only treatment 
required in this form of the disease, is some active anti- 
spasmodic. It may be distinguished from the Pseudo- 
membranous variety, by its sudden appearance at night, 
when the child was apparently well during the day, and by 
its almost as sudden disappearance on the administration 
of a few drops of Tinct. of Lobelia, and the application 
of a wet pack to the neck. 

The symptoms of the spasmodic kind, are a sudden 
hoarse cough, followed by a whistling and difficult respira- 
tion. 

The symptoms of the pseudo-membranous kind, are 
very insidious. The child is irritable, restless, and 
peevish, and at times has a fever. He will also be ob- 
served to spit frequently. These symptoms, in the course 
of from twenty-eight to thirty-six hours, will be followed 
by a slight cough, which increases, and the voice soon 
becomes hoarse. 
16* 



186 croup. 

The disposition to spit also increases, and the sputa, if 
examined, is found to be of an albuminous character, thus 
clearly indicating the nature of the disease. 

The symptoms are all aggravated at night, the pulse 
becoming quick, and the breathing laborious ; but in the 
morning, they are much ameliorated. In the afternoon, 
the symptoms again appear, and are greatly aggravated. 

The child throws his head back, and frequently grasps 
at the neck, the expectoration ceases, the breathing is 
more labored, and the pulse more frequent. He is unable 
to speak above a whisper, and unless relieved by proper 
treatment, soon becomes stupid and expires. 

TREATMENT. 

The treatment here recommended, is of a very simple 
character, and rather belongs to Prof. J. Gr. Jones than 
to myself. And as all other methods with which I have 
been familiar have almost universally failed, while this has 
always proved successful, I most confidently recommend it 
to the profession as the only radical cure ever offered for 
this hitherto almost invariably fatal disease. 

In the early stage, a thorough Podophyllin and Cream 
of Tartar cathartic should be given, the feet should be 
placed in hot water, and a cold wet pack applied to the 
throat. The pack should be changed sufficiently often to 
keep it cold. After which, the patient should be put upon 
a mild acetic syrup : 

R Sanguinaria Pulv gj. 

Acetic acid giij. 

White Sugar giij. 

Mix, steep for fifteen or twenty minutes, and give one half 
teaspoonful every half hour. This prescription should be 
continued as long as any symptoms of the disease remains. 
If the treatment is not commenced until the disease is far 
advanced, the cathartic should be omitted, and the syrup 



WORMS. 187 

given at once. The bowels should be moved by laxative 
enema, and the surface frequently sponged in tepid water. 

If the disease proves obstinate, two or three antiperiodic 
powders should be given during the Apyrexia. The 
syrup should also be continued. There should be no 
more of the syrup given than the stomach will* tolerate. 

The strength should be maintained by a generous diet, 
and all excitement should be avoided. 



WOBMS. 

According to the classification of the entozoist, the 
following are the different varieties that infest the alimen- 
tary canal : 

1st. Ascaris Lumbricoides, or common round worm. 

2d. Ascaris Yermicularis, or- thread worm. 

3d. Tricocephalus Dispar, or long thread worm. 

4th. Taenia Solium, or common tape worm. 

5th. Taenia Lata, or broad tape worm. 

The most common varieties of worms met with in this 
country, are the common found worm, mostly found in the 
small intestines, and the short thread worm, which inhabits 
the rectum or lower portion of the bowels. 

SYMPTOMS. 

The symptoms of worms are various. The most com- 
mon are frequent flashes of fever, which disappear in a few 
hours ; irregular appetite, irritable temper, symptoms of 
irritation about the fauces, tumefaction of the glands, fre- 
quent changes in the appearance of the urine, which is at 
one time scanty, and of a milky appearance ; at others, 
copious and limpid. The irritation will be so great at 
times as to affect the brain, and convulsions follow. If the 



188 WORMS. 

worms infest the rectum, there will be constant itching and 
uneasiness of that part, and at times a slight sanious 
discharge. 

TREATMENT. 

For the long round worm : 

U Santonine , gr. vj. 

Podophyllin g r «j- 

White Sugar gr. xxx. 

Mix, triturate, divide into twelve powders, and give one 
every three or four hours until they act upon the bowels. 
If this should fail, the following mixture may be given : 
5t Neutralizing mixture giij. 

Essence of Wormwood gj. 

Tinct. of Aloes- gss. 

Santonine gr. x. 

Mix, and give one teaspoonful three times a-day. 

Or — 

U Santonine „ gr. x. 

White Sugar gr. xxx. 

Triturate, divide into ten powders, and give one every night 
on going to bed. After two or three days, give a mild 
purgative. If the patient is troubled with Ascarides, in 
addition to the above, injections should be given : 

R Santonine gr. xx. 

Hydrastin gr. xx. 

White Sugar gj. 

Warm water t giv. 

Mix, and give as an injection every morning and evening. 
If either variety of the tape- worm afflicts the patient, the 
following mixtures may be given ; 

R Fresh Pumpkin-seeds after the shell is taken off ... gij. 
White Sugar gij. 

Bruise and mix. Give one teaspoonful every half hour 
until all is taken. After which give a brisk purgative of 
Podophyllin. If the first mixture does not succeed, it may 
be repeated. Or the following compound may be given : 



CHLOROSIS. 189 

R Oil of Male Fern gij. 

" Turpentine gij. 

" Red Cedar gj. 

" Worm Seed gij. 

Castor Oil giij. 

Mix, and give one teaspoonful every half hour until it 
operates upon the bowels. During the treatment for the 
tape-worm, the patient should abstain from food; and if 
the passage of the worm is commenced, it should be care- 
fully wound around a stick, to prevent it from being 
broken. 



ANEMIA, OR CHLOROSIS. 

SYMPTOMS. 

The symptoms of this disease are paleness of the skin 
and mucous surface, and a peculiar white appearance of 
the conjunctiva. When the disease has advanced for some 
time, the countenance assumes a sallow and bloated ^ap- 
pearance. The patient is feeble, and cannot bear much 
exertion. The circulation is irregular and weak ; the re- 
spiration, although natural when the patient is quiet, 
becomes labored on the least exertion, and there is fre- 
quently violent palpitation of the heart. 

The nervous system is most disordered ; vertigo, dizzi- 
ness, and feelings of fainting are not uncommon. At times 
there are violent neuralgic pains in the head, back, limbs, 
and side. In females the menses are almost entirely sup- 
pressed or altogether wanting. The blood in this disease 
is found to be deficient in iron. 

TREATMENT. 

R Carbonate of Iron gij. 

Port Wine Oj. 

Common Salt gij. 

Hydrastin ~ £j. 



190 MILIARY FEVER. 

Mix, and give one teaspoonful three times a day. If the 
patient is a female with partial or complete suppression of 
the menses, the following pill should be given : 

R Senecin , gr. xx. 

Macrotin gr. v. 

Vallee's mass gr. xxx. 

Podophyllin gr. j. 

Mix, form a mass, and make three-grain pills. Give one 
in connection with the wine tonic three times a-day. The 
diet should consist of rich animal broths, and the patient 
take plenty of out-door exercise. The bowels should be 
kept open by the use of some mild laxative, such as Apo- 
cynia and Euonymine. If the disease does not yield, the 
following compound may be given : 

]£ Brandy ....* Oss. 

Water Oss. 

Phosphate of Lime gij. 

Iron by Hydrogen gr. xxx. 

White Sugar giv. 

Mix, and give one tablespoonful three times a-day. The 
above treatment, together with cold baths, followed by a 
reaction, will generally prove effectual. 



MILIARY FEYER 

Is characterized by an irregular eruption of round vesi- 
cles of the size of a millet-seed, upon slightly elevated and 
inflamed patches of cuticle. 

It mostly commences with rigors and languor, a quick 
pulse, hot and dry skin, and thirst. The eruption gener- 
ally appears about the fifth or sixth day from the "com- 
mencement of the febrile attack. Previous to its appear- 
ance, there is a sense of pricking or itching of the skin. 
The patient complains of great precordial oppression, but 
is soon relieved by a profuse perspiration, and in the course 



MILIARY FEVER. 191 

of from three to five days the vesicles form into small 
scales, and fall off. 

The eruption is generally distinct, but is sometimes con- 
fluent. It is said rarely to affect the face, and different 
crops may appear in the same fever. It is mostly a symp- 
tomatic disease, and occasionally appears in the course of 
nearly all low forms of fever; — although it may be idio- 
pathic when it attacks those who have been previously 
weakened by fatigue, or a long exposure to damp and 
malarious atmosphere ; or who have been for a long time 
confined to a bad regimen. 

TREATMENT. 

As this disease is mostly dependent upon constitu- 
tional debility, caused by some previous difficulty, it will 
be of the first importance to ascertain the cause, and re- 
move it ; after which the skin should be thoroughly bathed 
in warm lye water, and small doses of Aconite adminis- 
tered until a free perspiration is produced. For the pur- 
pose of stimulating the secretions, and as a mild purgative, 
the following compound should be given : 

Euonyniin gr. iij. 

Irisin gr. ij. 

White Sugar, gr. xxx. 

Triturate, mix, divide into ten powders, and give one 
every hour until all are taken, or until they act upon the 
bowels. If the disease does not yield to this mild treat- 
ment, small doses of Quinine and Iron together, with an 
active, stimulating, and nutritious diet, should be resorted 
to. When the active stage of the disease is passed, the 
patient should be allowed a liberal quantity of porter, in 
connection with vegetable tonics and chalybeates.. If the 
disease is connected with a scrofulous diathesis, the com- 
pound syrup of Stillingia, with Iodide of Potassium, should 
be given until the patient is entirely restored. 



192 ROSE-RASH — NETTLE-RASH. 

ROSEOLA, OR ROSE-RASH, 

Is a fever attended with a rose-colored efflorescence, 
and not contagious. It has often been confounded with 
measles and scarlet-fever. It mostly depends upon indi- 
gestion, and seldom requires medical treatment. The 
diet should be regulated, and if the fever is troublesome, 
small doses of Aconite, and a gentle purgative of Neu- 
tralizing mixture, may be given. 



URTICARIA, OR NETTLE-RASH, 

Is characterized by circular elevations of the cuticle, of 
a red color, with a white spot in the centre. 

The eruption is generally preceded by gastro-intestinal 
irritation and fever. There is frequently restlessness, 
languor, and anorexia. If the eruption is extensive, the 
patient suffers much from the itching and heat which it 
occasions. This disease is frequently caused by excess in 
eating and drinking, also by undue heating of the blood. 
It may continue for an indefinite period, and reappear 
whenever the stomach becomes deranged. 

TREATMENT. 

The patient's diet should be well regulated, and all 
excesses carefully avoided. The surface should be freely 
bathed, two or three times a week, and a mild vegetable 
alterative and tonic be given. If the disease assumes a 
periodic character, as it sometimes does, an antiperiodic 
should be administered, succeeded by the following com- 
pound : 

R Cream of Tartar gr. xxx. 

Leptandrin gr. xx. 

White Sugar : gr. xxx. 

Triturate, mix, divide into ten powders, and give one 
three times a day. 



THE PLAGUE. 193 



THE PLAGUE. 



This disease is regarded as nothing more than a malig- 
nant typhus fever, attended during its course, by buboes 
and carbuncles. 

Mackintosh gives the following diagnostic symptoms of 
the Plague : 

It is ushered in by rigors and oppression, followed by 
heat of the skin, great prostration of strength, giddiness 
and headache. The expression of the countenance is be- 
sotted, and the eyes have a muddy glistening appearance. 

The intellect is sometimes cloudy, at others there is 
insensibility and fixed delirium. 

Occasionally, stupor takes place, and in some instances 
the functions of the brain remain distinct and clear. The 
patient in general seems indifferent respecting his fate. 
The tongue is at first moist, although it is more or less 
loaded. There is sometimes constipation, at others diar- 
rhaea. The stools are very offensive, and there is constant 
nausea and vomiting. About the third clay from the 
attack, there is acute pain, followed by redness and swell- 
ing in the arm-pits and groins, which terminates in car- 
buncles and buboes, unless it is immediately relieved. 
And unless suppuration soon takes place, death speedily 
follows. It is stated that if the patient survives the fifth 
day, and the buboes appear well-formed, the patient may 
be pronounced convalescent. The points of danger in 
this disease appear to be, the time in which the buboes 
ought to appear, and the time of maturation. For a full 
description of this disease, the reader is referred to the 
writings of Dr. James McGregor, who has described it 
minutely, as it appears in India and Egypt. 

It 



194 DIFFICULT DENTITION. 



TREATMENT. 



Cullin condemns both blood-letting and purgatives in 
this disease, and states that the chief object in the treat- 
ment should be to relieve the spasms of the extreme 
vessels. For this, he recommends the application of oil 
to the surface, and some antispasmodic internally. There 
can be no doubt that this disease requires a vigorous, 
stimulating, and antiperiodic treatment from the com- 
mencement. From all the information I can obtain, I 
should make a liberal use of hot alkaline baths, anti- 
periodics, and a free use of Aconite to control the fever. 
Also a liberal use of tonics, antispasmodics, and stimu- 
lants, with a nutritious diet. 



DIFFICULT DENTITION. 

Few children pass through the process of dentition 
without more or less suffering, and often a variety of com- 
plicated symptoms make their appearance, all depending 
upon one general cause, viz : dentition. It has long been 
observed, that children w r ho pass through the period of 
teething early, suffer less than those whose teeth are longer 
making their appearance. 

The ages at which children cut their teeth are various. 
There are instances of children being born with full sets 
of teeth, as is recorded of Richard the Third and Louis 
Fourteenth. In general, however, the teeth begin to 
appear between the age of six and eight months. The 
two centre incisors of the lower jaw, are commonly cut 
first, and are soon followed by those of the upper, after 
which the two lateral incisors of the lower, and then 
those of the upper jaw make their appearance. Between 
the twelfth and sixteenth months, the intergrinders of the 



DIFFICULT DENTITION. 195 

lower jaw appear, and next in succession are the cuspicles 
or eye teeth. The others soon follow, so that by the age 
of two years, the child has its complete set of teeth, 
twenty in number. The formation of each tooth goes on 
in a membranous and vesicular sack, which is firmly united 
to the gum. It is supposed that in tedious and difficult 
dentition, the sack becomes more vesicular, and is materi- 
ally thickened. This, together with the pressure of the 
teeth upon the gums, is supposed to be the only cause of 
the various ills incident to this period. 

The teeth are composed of Phosphate and Carbonate 
of Lime, Fluoride of Calcium and Cartilage. 

On analysis by Berzelius they were found to be com- 
posed of 

Cartilage and vessels 28.0 

Phosphate of Lime 64.3 

Carbonate of Lime 5.3 

Phosphate of Magnesia...... 1.0 

Soda with Chloride of Sodium 1.1 

According to Lessaigne, it appears that as the teeth « 
become older there is an increase of the Phosphate of 
Lime, and a corresponding diminution of the Carbonate. 
From the above facts, it seems the food should contain 
these elements, to enable the teeth to become perfectly and 
timely developed. The cause of the diseases so frequently 
identified with dentition, is a lack of the proper histo- 
genetic material, thereby causing a drain upon the other 
tissues, which, together with the long-continued irritation 
of the teeth upon the nerves, produces a train of morbid 
symptoms, which are attributed to anything but their true 
source. 

The child, under these circumstances, becomes restless, 
fretful and feverish, the sleep is disturbed, the bowels are 
irregular, the face is flushed, and in some cases there is 
slight spasmodic twitching of the muscles, and in others 
general convulsions. 



196 DIFFICULT DENTITION. 

Sometimes the child becomes troubled with an irritable 
cough, with wheezing, a hot skin, quick pulse and scanty 
urine, denoting great irritation of the bronchial and pul- 
monary tissues. Cutaneous and glandular affections often 
occur. The sub-maxillary glands are those most com- 
monly affected. Occasionally there is inflammation of the 
eyes, causing purulent Ophthalmia. 

The enumeration of the above symptoms will show the 
importance of a correct diagnosis in these cases. 

TREATMENT. 

There is no disease in which the ordinary allopathic 
treatment proves more mischievous than in this. 

The poor child has its gums scarified and mutilated to 
no purpose. In some cases its stomach and bowels are 
entirely destroyed by the drastic doses of Calomel, Rhu- 
barb, Prepared Chalk, and the like ; while in other cases, 
Opium, Paregoric, Godfrey's Cordial, Bateman's Drops, and 
a long catalogue of irritants and narcotics, tending still 
farther to depress the feeble vitality of the child, cause 
Dropsy of the Brain, Tabes Mesenterica, and Tuberculous 
Consumption. Now these medicines have not one particle 
of the aliment needed to build up the structure which is 
making such extensive drains upon the other tissues, and 
causing such derangement of the vital powers. The scari- 
fying of the gums frequently produces an irreparable injury 
[to the teeth, by denuding them of their soft enamel, an 
injury seldom repaired. Hence the frequent premature 
decay of the teeth. The proper treatment consists in 
administering in small quantities those elements of which 
the system is deficient. For instance : 

R Phosphate of Lime..... gr. xx. 

Carbonate of Magnesia gr. x. 

Phosphate of Iron gr. v. 

Simple Syrup giij. 



DIFFICULT DENTITION. 197 

Dose, one teaspoonful three or four times a day. If there 
is fever, a few doses of Aconite, given at intervals of from 
half an hour to an hour, will be sufficient to control it. If 
the disease proves persistent, or assumes a periodical 
character, Quinine may be given in combination with some 
of the other articles, or alone as indicated. If Bronchial 
irritation is the prominent symptom, two or three drops of 
the Tct. of Veratrum may be given every three or four 
hours until the symptoms subside. If there is diarrhoea, 
Neutralizing Mixture, with small doses of Geranin, should 
be given. The surface should be frequently bathed, and 
the diet should be nutritious and of easy digestion. The 
Lime, Magnesia and Iron should be continued from time 
to time until dentition is complete. 

Many cases might be adduced to illustrate this mode of 
treatment, but one will suffice. 

In June, 1855, I was called to see a child fourteen 
months old, in which the teeth had not made their appear- 
ance. 

The Doctor (Allopathic) had pronounced it to have 
Pneumonia. It had been afflicted with alternate diarrhasa 
and costiveness for three months, and on two or three 
occasions had had convulsions. Its gums had been lanced 
eight or ten times. I immediately ordered Magnesia, 
Lime and Iron, with small closes of Quinine, and a good 
diet, and in three weeks the constitutional difficulties had 
disappeared, and the teeth had begun to make their ap- 
pearance. In the course of six months, by the occasional 
use of the above remedies, the teeth were fully developed, 
and the child restored to perfect health. 



IT* 



198 OESOPHAGITIS. 

INFLAMMATION AND ULCERATION OF THE 
(ESOPHAGUS. 

There is no structure in the human body more exempt 
from disease than the oesophagus ; but when it becomes 
inflamed, it is quite difficult to detect it until ulceration 
and constriction take place. 

Inflammation may be partial, affecting only a small 
portion of the oesophagus, and if ulceration occurs, there 
will be no contraction ; but the patient will feel slight 
pain, and there will be momentary stoppage of the food as 
it passes on to the stomach. If the whole caliber is in- 
flamed, the difficulty of swallowing will be much greater, 
not so much owing to the stricture of the oesophagus, as 
to the constant tendency to vomit. There will be more or 
less constitutional symptoms, as debility, hot skin, scanty 
urine, &c. Not unfrequently the entire system materially 
sympathizes with the local affection. 

TREATMENT 

The constitutional symptoms should be removed, and at 
the same time an irritating plaster should be applied to 
the throat, or the region of the inflamed and ulcerated 
parts, and caused to remain until a free discharge ensues. 
The bowels should be maintained in a soluble state, and 
the skin freely bathed in hot lye water and whiskey as often 
as two or three times a week. And the following com- 
pound should be administered : 

U Syrup of Marshmallow ^iij. 

Syrup of Iodide of Iron , gij. 

Compound Syrup of Stillingia gj. 

Mix, dose one teaspoonful three times a day. The diet 
should be nutritious and easy of digestion, and every pos- 
sible exertion should be made to maintain the integrity of 



GASTRODENIA. 199 

the constitution. If the ulceration proves unyielding, a 
strong solution of Hydrastin, to which may be added a 
few drops of the Tct. of Iodine, may be taken in reason- 
able doses three or four times a day. 

If the above treatment should not prove successful, the 
application of a mild solution of nitrate of silver may be 
made once or twice a week by means of a probang. The 
above remedies will be sufficient to effect a cure, provided 
the cause of the disease has received due attention. 



GASTRODENIA. 

Gastrodenia is a neuralgic affection of the stomach, and 
is closely allied to dyspepsia, and in some instances ap- 
pearing as one of its symptoms. Sometimes the appetite 
remains good, but generally it is impaired. There is 
gnawing pain in the stomach, extending to the back, 
accompanied with anxiety and sense of constriction, with 
a strong tendency to vomit. There is constipation of the 
bowels, and more or less pain in the head. The principal 
causes of this disease are the long-continued use of indi- 
gestible food, very warm or very cold drinks, or the use 
of Alcoholic drinks, schirrous and cancerous affections of 
the stomach, &c. 

TREATMENT. 

If the disease is dependent, either upon irregularities of 
eating or drinking, or upon the excess of either, this should 
be carefully avoided. During the attack, much benefit 
may be derived from an emetic. 

R Lobelia Seed Pulv gr. x. 

Bayberry Bark Pulv gr. xxx. 

Mix, add one half pint of warm water, two tablespoonfuls 
of milk, sweeten, steep fifteen minutes, and give a wine-glass 
full every fifteen minutes till it operates freely as an emetic. 
After which, 



200 HAMATE MESIS. 

U Lupulin gr. x. 

Scutellarin ., gr. xx. 

Leptaudrin gr. xxx. 

Mix, triturate ; divide into fifteen powders, and give one 
every three or four hours. If the pain still continues in 
the stomach, small doses of Morphine may be taken at bed- 
time. The constitutional symptoms should be carefully 
attended to, and if the disease becomes periodical, one of 
the antiperiodic preparations should be administered. The 
diet should consist of animal and vegetable broths, and 
the body well bathed in warm or cold water as often as 
three or four times a week. 



HJ1MATBMESIS. 

This disease most frequently attacks women, particularly 
those who are of a plethoric habit, and at times when there 
is a suppression of the catamenia. Each attack is gene- 
rally preceded by rigors. Pure blood is seldom vomited, 
unless caused by internal violence or corrosion of the 
vessels of the stomach. The blood seldom coagulates, and 
seems to be the product of passive hemorrhage, or exuda- 
tion from the minute vessels of the mucous membrane. 

The diagnostic symptom of hemorrhage from the sto- 
mach is a sense of weight and pain in that region, unac- 
companied by cough. Every part of the mucous mem- 
brane of the alimentary canal is perhaps equally liable to 
passive hemorrhagic exudation. 

Occasionally the disease is so general as to give rise to 
a sanguineous cholera. In some instances it is confined to 
the bowels, the stomach not participating in it. The most 
alarming intestinal hemorrhage is called meleena, and is 
characterized sometimes by full discharges of black blood, 
resembling ink mixed with sand ; but at others, it is more 
of a sanguineous character. Hemorrhage from the stomach 



HEMORRHAGE, 201 

and bowels produces great exhaustion, and unless relieved, 
soon proves fatal. This disease frequently accompanies 
some form of fever, especially typhoid fever. When the 
hemorrhage is from the stomach, it is a less fatal symptom 
than when it occurs from the bowels ; yet it rapidly 
exhausts the patient, and frequently proves disastrous, 
unless timely relief is given. 

T R E A T M E N T . 

Iii hemorrhage from the stomach or bowels, an infusion 
of matico, in connection with the ligatures, and hot 
turpentine and mustard sinapisms, will generally give re- 
lief. If the patient is an adult, give two or three table- 
spoonfuls of a strong tea, made of the matico leaves, every 
five minutes*. At the same time apply the ligatures to the 
arms and legs ; also, a sinapism over the stomach or 
bowels, as the case may be, made by taking one table- 
spoonful of mustard, four tablespoonfuls of pulverized slip- 
pery elm, and one of oil of turpentine, mixed with hot 
water, and applied as warm as the patient will bear it. The 
matico tea should be continued until the hemorrhage 
ceases, or for one or two hours. If it proves ineffectual, 
a pill may be given, made as follows : 

B: Nitrate of Silver gr. j. 

Geranin gr. x. 

Pulv. GuraArabic gr. xxx. 

Triturate, and make sixteen pills. Give one every half 
hour while the hemorrhage continues. After which the 
patient's strength should be well supported by vegetable 
tonics, iron, and a generous diet. If the hemorrhage 
should be owing to a suppression of the catamenia, the 
feet should be immediately placed in a tub of warm water, 
and a large Galbanum plaster applied along the spine and 
across the lower portion of the abdomen. Also, ten or 
fifteen drops of the oil of Erigeron should be given every 



202 JAUNDICE. 

fifteen minutes, until the hemorrhage ceases. After which 
the patient should be treated as directed under derange- 
ment of the menses. 



JAUNDICE, OR YELLOWNESS. 

This appearance is owing to the deposit of the coloring 
matter of the bile in the skin and other tissues and fluids. 
This substance must be presumed to exist in the blood of 

. the jaundiced patient, and it is claimed to be found in 
healthy blood. But the prevalent belief is* that the bile- 
pigment is absorbed after having been secreted by the 
liver : an opinion founded upon the most common cause 
of jaundice, i. e., the obstruction of the ductus communis, 
or one or more of the branches of the hepatic duct, by a 
gall stone, or by the pressure of a tumor, &c. But among 
the most common causes of jaundice is a deficiency of the 
secreting cells of the liver ; consequently no biliary secre- 
tion takes place. Jaundice is considered by some as an 
idiopathic disease, but it is mostly a symptom of some spe- 
cific difficulty, and for which it serves as a diagnostic 
symptom. It is a phenomenon of several fevers, viz. : 
bilious remittent and yellow ; also of different affections 
of the liver, gall-ducts, and stomach. When it comes on 
with indigestion, slight fever, sluggishness, and pain in 
the hypochondrium, it may be regarded as a functional 
disease of the liver and stomach. But when it follows vio- 
lent and spasmodic pain in the region of the liver, it is 
dependent upon the arrest of gall-stone in the biliary pas- 
sage. When it precedes delirium or coma and convul- 
sions, it indicates disorganization of the hepatic cells ; and 
when it comes on slowly and lasts a long time, and acquires 
a dark tinge, it depends either upon organic disease of the 

* liver, or some of the neighboring organs obstructing the 
discharge of bile into the duodenum. The symptoms of 



JAUNDICE. 203 

jaundice, excepting the yellowness, depend much upon the 
cause of the difficulty, though in all cases the skin is husky 
and dry ; the urine partakes of the color of the skin ; the 
faeces are either of a dough or grey-ash color, and in most 
cases there is constipation of the bowels. The other symp- 
toms vary in different cases. 

TREATMENT. 

The treatment of this disease should depend entirely 
upon its cause as indicated by the symptoms connected 
with it. If it depends upon a functional disorder of the 
liver, the following compound may be given : 

Euonymine gr. x. 

Podophyllin gr. ij. 

Gelsemin gr. j. 

White Sugar gr. xxx. 

Mix, triturate, divide into six powders, and take one every 
two hours. After which — 

U Phytolaccin ... gr. vj. 

Flour of Sulphur gr. xxx. 

Extract Dandelion jj. 

Make twenty pills, and take one four times a day. The 
surface should be freely bathed, and the diet should be 
easy of digestion. After the pills are taken, the following 
may be given : 

R Cream of Tartar ,.. gij. 

Sanguinarin gr. x. 

Sulphur gr. xx. 

Iron by Hydrogen gr. xx. 

Best Gin Oj. 

Mix, and take one tablespoonful three times a-day. When 
the disease is dependent upon the arrest of gall-stone in 
the biliary passage, a thorough Lobelia emetic should be 
given, followed by a spirit-sweat and a brisk purgative, as 
follows : 



204 DISEASES OF THE HEART. 

1£ Podophyllin « gr. ij. 

Cream of Tartar gr. x. 

Gelsemin • gr. ss. 

Mix, triturate, and divide into four powders, and give one 
every two hours until it operates as a cathartic. 

If the above prescriptions fail to give relief, they should 
be repeated at proper intervals. 



DISEASES OF THE HEART. 

The most common disease of this organ is fluttering or 
palpitation. This may be connected with various structural 
changes in the organ, yet it frequently exists independent 
of any such change. " The distinction between organic and 
functional disease of the heart," says Dr. Walshe, " is far 
from being easily made. Many of the general rules given 
for this purpose fail clinically. " The inconstancy of func- 
tional and the constancy of organic ailment are strongly 
dwelt upon for examples. But all the subjective and many 
of the objective symptoms may disappear temporarily in 
cases of extensive organic disease. The existence of secon- 
dary changes, such as sub-cutaneous oedema, congestion 
of the lungs, &c, commonly proves the cardiac affection to 
be organic, but not always ; for spansemia, added to ner- 
vous palpitation, may induce oedema. If exercise relieves 
a disturbed condition of the heart, its affection is pro- 
nounced to be dynamic only ; but if spansemia exist, exer- 
cise may be unbearable. From these remarks of Dr. 
Walshe, it will be perceived that without much care, func- 
tional and organic disease of the heart are liable to be con- 
founded. Indeed, nothing was more common than this, 
previous to the discovery of physical diagnosis and their 
complete elucidation by Laennec. And now, without re- 
peated physical examinations, even an adept in this method 



DISEASES OF THE HEART. 205 

of diagnosis may mistake mere irregularity of rhythm for 
structural cardiac disease ; as it is now universally admit- 
ted that palpitation, when connected with spansemia, will 
not only produce a basic systolic murmur, but a systolic 
murmur at the mitral apex may be generated by the irregu- 
lar action of the musculi papillaries, and even the area 
of dulness may be extended temporarily, owing to the dis- 
tension of the cavity of the heart with blood. 

SYMPTOMS OF DYNAMIC PALPITATION. 

According to Laennec, the first impression conveyed by 
the stethescope is, that the heart is not enlarged. The 
sound is not heard loudly over a great extent, but this de- 
pends very much upon the thickness of the chest. Laennec 
states that in nervous palpitation of the heart, the heat 
of the patient is never sensibly elevated by the increased 
action of the heart, which is the case in organic disease of 
this organ. This may be true as a general rule, but is far 
from being universally so, as my own professional expe- 
rience has proved. Dr. Walshe states that in nervous affec- 
tions of the heart, the area of dulness remains unaltered ; 
but that distension to the right of the sternum may occur 
in prolonged paroxysms. He states also that the first 
sound is too loud and clear at the mitral apex, and some- 
what abrupt and short. The sound is duller and less click 
ing than is natural at the mid-sternal base. The first sound 
may be loud enough to be audible both to the patient and 
to the bystanders at a distance of some inches from the 
chest. Reduplication of the second sound at the base is 
common ; and a clear metallic ring or a praecardial rub 
may accompany the shock at the mitral apex. 

Prof. Calkins remarks, that in order to form a correct 

diagnosis, we should recollect that the character of organic 

disease of the heart is to progress ; that of functional to 

occur at regular intervals; that active exercise almost 

18 



206 DISEASES OF THE HEART. 

invariably aggravates organic, but seldom increases the 
symptoms of functional ; that the physical signs generally 
are soon developed, and remain permanent in organic, 
while they seldom exist — and when they do, they arise 
from chlorosis — in functional. The rational symptoms, 
which more frequently occur in nervous disease of the heart, 
than in functional, are choking in the throat, precordial 
anxiety, with faintness and actual syncope, or active pains 
simulating angina. The pulse beats with increased fre- 
quency, and there is a clammy coldness of the extremities, 
with a flushed face. The fits of palpitation may last for a 
few minutes, or they may last for hours, or even days. 

TREATMENT. 

During the paroxysms, the remedies should be of such 
character as to lessen their intensity, and, if possible, at 
the same time to remove the cause. If this cannot be done, 
the paroxysm should be relieved, and an effort made to 
remove the cause afterwards. For the purpose of relieving 
the paroxysm, 

U Gelsemin gr. j. 

Scutellarin gr. x. 

Cypripedin,... gr. xv. 

White Sugar gr. xxx. 

Mix, triturate ; divide into eight powders, and give one 
every hour until the paroxysm is relieved. At the same 
time, the feet should.be bathed in warm water, and the 
patient should avoid all mental and bodily excitement. 
After which, if there is spansemia, 

U Quinine gr. x. 

Iron by Hydrogen '. gr. xij. 

Hydrastin gr- xj. 

"White Sugar gr. xxx. 

Mix, triturate ; divide into ten powders, and give one 
three times a day. The diet should be generous, and the 
following tonic should succeed the powders : 



ANGINA PECTORIS. 207 

R Scutellarin gr. xx. 

Precipitated Carbonate of Iron. gr. xxx. 

Caulophyllin gj. 

White Sugar lbss. 

Mix, triturate ; add to one pint of good port wine, and 
take one tablespoonful three times a day before eating. 
The bowels should be kept in a free state by the use of 
Leptandrin and Neutralizing Mixture, and the patient 
should avoid all undue exercise. 



ANGINA PECTORIS. 

This is a disease characterized by paroxysmal pains and 
tenderness in the precordial region, extending to the head, 
shoulders, arms and legs, and in some cases producing 
numbness. The pain is sudden in its onset, but is mostly 
of a dull character, although in. some. cases it is lancinating 
or tearing, producing exquisite torture and contractive 
suffocation. There may be slight dyspnoea or orthopnoea, 
with lividity of the countenance. The heart usually pal- 
pitates, the extremities become cold, the urine is passed in 
large quantities, and is mostly of a limpid appearance. 
The bowels are constipated, and in most cases there is 
more or less constitutional disturbance for some time pre- 
vious to the attack. If there are cardiac murmurs in con- 
nection with the disease, there is reason to apprehend that 
it is connected with some organic difficulty of the heart. 
This disease may be a pure neuralgic affection of that 
organ, accompanied by hysteria and anaemia, or it may be 
of a periodic character, of miasmatic origin, — a mere 
masked ague — or it may depend upon some organic 
disease of the heart. 



208 CONGESTION, 

TREATMENT. 

In this affection, the first object should be to relieve the 
urgent symptoms. For this purpose, the feet should be 
placed in hot water, a large sinapism applied over the 
region of the heart, and the patient caused to take one 
drop of Aconite every five minutes until the symptoms are 
relieved. If they are not relieved in the course of half an 
hour, the following compound should be given : 
R Lobelin gr. j. 

Lupulin gr. vj. 

Hyosciamin gr. ij. 

White Sugar gr. xxx. 

Mix, divide into ten powders, and give one every ten 
minutes until relief is obtained. As soon as the severity 
of the paroxysm is relieved, the cause of the disease should 
be ascertained, and such a course pursued as will effect a 
permanent cure. Antiperiodics should be given where the 
disease is produced by miasm, chalybeates and tonics 
where it is dependent upon anaemia, and if it originates in 
organic disease of the heart, the proper treatment may 
be found under that head. 



CONGESTION, OR, ACCUMULATION OF BLOOD 
IN THE CAVITIES OF THE HEART. 

Congestion, or accumulation of blood in the cavities of 
the heart, may occur in consequence of fibrinous deposits 
interfering with the free movement of the valves. This 
deposit seems mostly to be a product of endocarditis, 
although it may arise from regurgitation during fits of 
dyspnoea, and whenever there is sudden obstruction of the 
circulation through the lungs. 



PERICARDITIS. 209 



SYMPTOMS. 



These are orthopncea, cough, lividity of the countenance, 
oppression and anxiety. The physical signs are extended 
area of dulness, irregular rhythm and a labored impulse 
of the heart. Dropsical effusions and anaemia are fre- 
quently produced by this disease. 

TREATMENT. 

Give a free purgative of Podophyllin and Cream of 
Tartar, followed by Syrup of Marshmaliow and Iodide 
of Potassium. If the disease proves obstinate, an irrita- 
ting plaster should be placed over the region of the heart, 
and allowed to remain until a free discharge* ensues. 
Aconite should be given to control the circulation, and 
the diet should be nutritious. 



PERICARDITIS, OR 1XFLAMMATIOX OF THE 
PERICARDIUM. 

The symptoms of this disease depend much upon the 
state of the inflammation, during the first stage of the 
inflammatory process. There is more or less fever, with 
increased frequency of the pulse, cough and dyspnoea. 
The physical sign is a sound of grating friction. In the 
second stage, which is that of exudation, there is pain in 
the region of the heart, irregular pulse, anxiety, dyspnoea, 
cough, and a tendency to syncope. The features are 
sharp, and indicate distress. There is scanty and high- 
colored uriue, with alternate fever and apyrexia. 

The physical signs are frictional sound, and valvular 

murmurs, dependent upon endocarditis. In the third 

stage, bulging of the precordial region may be observed, 

and if there is extensive effusion, displacement of the apex 

18* 



210 PERICARDITIS. 

of the heart upwards. The area of dulness will be 
changed, and very materially enlarged. The sound of 
the heart will be indistinct and muffled. If adhesion of 
the pericardial surface to the heart should occur, the 
action of the heart will be tremulous and unsteady. As 
the disease advances, the head* is kept elevated, or- 
thopnea is a constant symptom, and the patient dreads 
movement of any kind. In fatal cases risus sardonicus 
often occurs, with tenderness of the Epigastrium, Spas- 
modic dysphagia, nausea, and vomiting, quasimania, 
stupor, and death. Or the severity of the symptoms may 
gradually yield, and the patient recover. 

CAUSE. 

This disease may be caused by metastasis of inflamma- 
tion from other parts, as in pleuritis, pneumonia, rheuma- 
tism, phlebitis, &c, and in some cases it is said to be 
idiopathic. 

TREATMENT. 

In the first stage of this disease, the bowels should be 
opened by full doses of Podophyllin and Cream of Tartar, 
a warm sinapism should be applied over the region of the 
heart, and the surface thoroughly bathed in lye water and 
whiskey. The operation of the cathartic should be fol- 
lowed by from one to five drops of the Tinct. of Aconite 
every hour, until free diaphoresis ensues. This course 
will control the active form of the inflammation, after 
which the patient should take the following diuretic and 
alterative mixture : 

R Syrup *of Marshmallow gv. 

Iodide of Potassium gss. 

Mix, and give one teaspoonful every three hours. At the 
same time, give from five to ten drops of the Muriated 



ENDOCARDITIS. 211 

Tinct. of Iron every five hours. If the disease should he 
of a periodic character, from five to ten grains of the 
Sulphate of Cinchonin, and one-eighth of a grain of 
Gelsemin should be given every three or four hours until 
that symptom is controlled. If extensive effusion should 
occur, from one-eighth to one-fourth of a grain of Phyto- 
laccin to the Syrup of Potassa and Marshmallow, may be 
added. If, after the active symptoms of the disease, there 
should still remain some cardial disturbances, the acetic 
syrup of Sanguinaria will generally suffice to control them. 



ENDOCARDITIS. 

The symptoms of this disease are pain and uneasiness 
in the region-.of the heart, with precordial pressure. The 
decubitis is dorsal. The skin is hot, the countenance is 
livid, and there is cough, dyspnoea, and tendency to syn- 
cope. The physical signs are uneasiness, and increase of 
the action of the heart, and a grating accompanying the 
bellows sound. The normal systolic murmurs will be 
changed, corresponding to the stage of the disease. 

TREAT M ENT. 

The treatment of endocarditis, is essentially the same 
as in pericarditis. The surface should be bathed in lye 
water, a warm pack applied over the cardiac region, and 
Aconite or veratrum given until the active stage of the 
disease is removed. These should be followed by diu- 
retics, alteratives, and tonics. 



212 CARDITIS — ATROPHY. 



CARDITIS, OR INFLAMMATION OP THE 
SUBSTANCE OF THE HEART. 

This disease is mostly connected with endocarditis or 
pericarditis, and even when it exists as an idiopathic dis- 
ease, its symptoms are so closely allied to them that as yet 
the diagnostic symptoms are very obscure. The treatment 
should be the same as of inflammation of its membranes. 



ATROPHY OF THE HEART. 

In valvular atrophy, says Dr. Walshe, when the chordae 
tending of the mitral valve are shortened or extremely 
thin, they are probably purely atrophous.; the large 
tongue of the valve is simply defective in size, without 
obvious puckering, or other evidence of past inflamma- 
tion : in either case regurgitation may occur. The sig- 
moid and pulmonary valves may also become atrophous, 
causing regurgitation in the aorta and pulmonary veins ; in 
the former producing syncope, in the latter asphyxia. 

The physical signs are regurgitation with bellows sound. 
Where there is atrophy of the parenchyma of the heart, 
the area of dulness will be diminished, and the diastole 
and systole will both be feeble. 

The rational symptoms are pallor, coldness of the ex- 
tremities, cough, irregular respiration, palpitation, pre- 
cordial oppression, cedema of the extremities, and in 
females, irregularities of the catamenia, haemoptysis, and 
it frequently terminates in dropsy and phthisis. In old 
age, the valves of the heart becoming atrophied, fre- 
quently causes pulmonary apoplexy. 



HYPERTROPHY OF THE HEART. 213 



TREATMENT. 

The patient should avoid all excesses, in mental and 
bodily exercise. The diet should consist of rich animal 
broths, with a liberal amount of fats and sugar. Give the 
following compound : 

R Precipitated Carbonate of Iron ^j. 

Hydrastin spj. 

'White Sugar ..., giij. 

Port Wine Oj. 

Water Oss. 

Dose, one tablespoonful three times a day. If there is 
much irregularity in the action of the heart, one grain of 
Myricin, and one-sixteenth of a grain of Teratrin, given 
twice or three times a day, will usually give relief. In 
old age, much benefit is sometimes derived from a mode- 
rate quantity of malt liquor once or twice a clay. 



HYPERTROPHY OF THE HEART. 

By this disease, is understood thickening of one or 
more of the cavities of the heart. It may exist with, or 
without other affections of this organ. The difficulties 
with which it is most frequently connected are dilatation 
and ossification of the valves. It is said that hypertrophy 
is mostly confined to the ventricles, and that it is more 
commonly met with in the left ventricle, than the right. 
This may sometimes be true, yet, in my practice, it is far 
from being generally so ; as in some thirty cases of both 
complicated and uncomplicated hypertrophy, the majority 
occurred in the auricles. Hypertrophy of the heart may 
be caused by a preternatural determination of blood to 
the organ, from a latent form of inflammation, or it may 
arise from a long-continued increase of action dependent 
upon nervous disease. 



214 HYPERTROPHY OF THE HEART. 
SYMPTOMS. 

The symptoms of hypertrophy of the left ventricle are a 
sensible, constant increase of the action of the heart ; the 
pulse strong, full, and vibrating. On percussion the area 
of dulness is extended ; and on auscultating the chest, the 
sound of the heart will be found very much enfeebled, and 
if hypertrophy is connected with dilatation, the diastole 
will be materially prolonged. In this way we may be ena- 
bled to distinguish between simple hypertrophy and that 
accompanied with increase in the capacity of the cavity. 
In hypertrophy of the right ventricle, the signs are very 
nearly the same as above, except the shock of the heart's 
action will be felt at the base of the sternum, instead of 
between the fifth and sixth ribs, as in hypertrophy of the 
left side. 

In hypertrophy of the ventricles, the impulse will be 
much increased, and the systole shortened in duration, 
while the diastole will be prolonged. The diseases pro- 
duced by these cardiac derangements are : dropsy, haemop- 
tysis, asthma, tubercles, phthisis, and asphyxia. 

TREATMENT. 

In treatment of hypertrophy of the whole or different 
portions of the heart, all stimulating articles of food and 
drink should be avoided, as also the use of tobacco. To 
lessen the action of the heart, and thereby prevent the 
abnormal supply of nutrition, is another essential element 
of the treatment. For this purpose a sufficient amount of 
Tct. Veratrum Yiride maybe given, say from five to ten drops 
three or four times a-day. The pulse should be maintained 
at about fifty-five or sixty by the use of the Yeratrum. At 
the same time one teaspoonful of the solution of Iodide of 
Potassium should be taken three times a-day. If the disease 
proves persistent, and should not yield to this plan of treat- 



DILATATION. 215 

ment, from one-eighth to one-fourth of a grain of Phyto- 
lacca may be given every night at bed-time. The bowels 
should be moved once or twice a- week, with Podophyllin and 
Cream of Tartar, and the patient should avoid all mental 
and bodily excitement. 



DILATATION, OR ENLARGEMENT OF THE 
CAVITIES OF THE HEART. 

Dilatation may be confined to one cavity of the heart, or 
it may extend to all. The cause of this disease, says Dr. 
Bertin, is owing to some obstruction in the circulation of 
the blood, as diseases of the valves, &c, while Laennec 
attributes it to congenital disproportion in the parts of the 
heart, But what is a more common cause of the disease 
in this country is an impoverished state of the blood, pro- 
ducing a weak and lax state of the muscles, thus giving 
rise to dilatation. 

SYMPTOMS. 

The patient is often attacked with violent dyspnoea and 
palpitation, followed by a weak and feeble pulse ; ten- 
dency to syncope, and in some cases nausea and vomiting. 
The bowels are mostly constipated, and there is frequently 
pain and precordial pressure. According to Laennec, the 
most constant and characteristic sign of this disease is 
a swollen state of the jugular veins without pulsation. 

TREATMENT. 

The principal classes of medicines indicated in this dis- 
ease are tonics and astringents, such as Hydrastin, Macro- 
tin, Myricin, and Muriated Tincture of Iron. The diet 
should be fall and nutritious, and the patient allowed to 
drink porter or ale once or twice a-day, with his meals. 
The Muriated Tincture of Iron should be taken in from 



216 PHLEBITIS AND PHLEGMASIA DOLENS. 

five to ten drop doses three or four times a day in a small 
quantity of beef tea or starch water. The Macrotin, Myri- 
cin, and Hydrastin, should be used in the form of a syrup 
two or three times a-day. 



PHLEBITIS AND PHLEGMASIA POLENS. 

Phlebitis is inflammation of the inner membrane of a 
vein. It may occur as the effects of blood-letting, the 
application of ligatures, pressure upon some venous trunk, 
&c. The pathological effects of inflammation of the veins 
vary according to the extent and severity of the inflamma- 
tion. In most cases the affected vein is swollen, thickened, 
and indurated to such a degree as to very much resemble 
an artery. A diffused swelling, connected with acute pain, 
coated tongue, scanty urine, constipated bowels, and py- 
rexia, are among the prominent symptoms of this disease. 
Upon examination, the adipose, cellular, and subcutaneous 
tissues are found to be filled with fluid ; and when the parts 
are laid open, clots of blood and lymph are found adhering 
to the inner coats of the veins. If the inflammatory pro- 
cess continues, the clots of blood and lymph are converted 
into purulent matter, rupturing the vessels, and forming a 
deep phlegmonoid abscess in the adjacent tissue. 

Phlegmasia Dolens is an inflammation of the veins of 
the leg, mostly caused by pressure of the gravid uterus, 
upon the iliac and other veins, generally making its ap- 
pearance on the second or third week after delivery. It 
occurs for the most part in one leg, exhibiting to the touch 
numerous irregular prominences under the skin. 

fYMP T QMS. 

In the course of two or three weeks after confinement, 
pain and uneasiness are complained of in the hypogastric, 



PHLEBITIS AND PHLEGMASIA D0LENS. 217 

lumbar and inguinal regions On examining the limb, it 
will be found tense, elastic and shining, mostly painful to 
the touch. It will also be flexed. 

The skin will be hot, the pulse quick, with great thirst 
and restlessness. If the disease is allowed to advance, the 
tongue will be covered with a dark sordes, the respiration 
becomes hurried, and delirium, coma, and death, rapidly 
follow. Or the symptoms will continue in a mild form for 
weeks, or even months, and the patient recovers, but with 
a shattered constitution. 

The above are the most ordinary symptoms, yet they 
vary exceedingly in different cases. Sometimes the pain 
commences in the knee, and is of a sharp darting character, 
extending to the groin. The limb is but slightly swollen, 
-and cold, but has a peculiar glistening appearance. The 
secretions of milk will be interrupted, and the bowels 
irregular. At other times the disease will assume a decided 
periodic character. The symptoms, such as pain, redness 
and fever, will all become exceedingly aggravated, at a 
certain stated period, and remain so for a few hours, 
followed by a distinct remission ; or the disease may be 
transferred to other organs, as the peritoneum, pleura, or 
lungs, producing extensive organic disease of those organs, 

TREAT M E NT. 

The treatment of phlebitis, when it is traumatic, con- 
sists in the application of warm emollient poultices, as 
slippery elm, saleratus and myrrh, kept moist with the 
Tinct. of Arnica, and the administration of brisk purga- 
tives of Podophyllin and Cream of Tartar, or Cream of 
Tartar and antibilious physic, succeeded dv a mixture as 
follows : 

U Muriated Tinct. of Iron gss. 

Pure Water gvi. 

Sulphate of Cinchonin.. ....... gss, 

19 



218 PHLEBITIS AN© PHLEGMASIA DOLENS. 

Mix, and give one teaspoonfal five or six times a day. If 
there is fever, Aconite or Yeratrum should be given to 
eontrdl it. The purgative should be repeated as often as 
indicated. After the swelling is subdued, the limb should 
be evenly bandaged, and kept wet with the Tinct. of 
Lobelia. 

In Phlegmasia Dolens, the poultice should be applied 
with a bandage over it. A purgative should be given 
similar to that in traumatic phlebitis, succeeded by the 
following compound : 

]J Sulphate of Bebeerine gr. xxx. 

Caulophyllin gr. xj. 

White Sugar , gr. xxx. 

Mix, triturate ; divide into ten powders, and give one 
every three hours. . Aconite may be given to control the 
fever, and the back, hips, and lower part of the bowels be 
bathed in a liniment prepared as follows : 

R Oil of Turpentine gj. 

Eggs v. 

Common Salt gss. 

Mix, and use two or three times a day. If the disease 
should assume a periodic character, 

U Muriated Tinct. of Iron gss. 

Water gij. 

Quinine , gr. xx. 

Give one teaspoonful every three or four hours. The sur- 
face should be thoroughly bathed, and if practicable, a 
spirit-sweat given once or twice a week. When the active 
stage of the disease has passed, small doses of Carbonate 
of Iron, with Euonymine, may be given three or four times 
a day. If there should be a chronic diseased condition of 
the vessels of the limb, the bandage should be continued, 
and kept moist by vegetable astringents. The patient 



BLUE SKIN DISEASE. 219 

should also take Iodide of Potassium in connection with 
tonics. The diet should be full and nutritious, and entire 
rest should be enjoined. 



CYANOSIS, MORBUS CERULEUS, OR BLUE 
SKIX DISEASE. 

This disease is confined to infants. The symptoms are 
a peculiar livid or blue appearance of the skin, frequently 
extending to the mucous membrane of the mouth. There 
is constant cough, dyspnoea, and palpitation. In some 
cases the dyspnoea becomes so excessive, as to produce 
syncope and death. 

The causes of these symptoms have been shown by Dr. 
Giritrae, to be as follows : 

, In 22 cases, the aorta was found to arise from both 
ventricles. 

" 30 " the foramen ovale was open. 

" 14 " the ductus arteriosus was open. 

" 4 " a single heart with one auricle and ven- 
tricle. 

11 5 li the ventricular septum was imperfect. 

" 22 " the pulmonary artery was contracted. 

" 5 " the pulmonary artery was obliterated. 

11 1 " the aorta was obliterated. 

r< 4 u the aorta arose from the right ventricle. 

The above table shows that this disease is mostly de- 
pendent upon congenital deformities of the heart and its 
appendages. 

TREATMENT. 

But little can be done in the treatment of this disease, 
more than to give temporary relief. Where there is syn- 
cope, the child should be placed in a warm bath, and 
ammonia or camphor applied to its nostrils. After which 
it should be wiped dry, and wrapped in a warm flannel. 



220 HEADACHE. 

For the cougli one or two drops of the Tinct. of Lobelia 
should be given in a teaspoonful of breast milk. The 
action of the heart may be regulated by Aconite, and in 
some cases, where the deformity is only partial, the child 
will gradually recover. 



HEADACHE. 

This is frequently a mere symptom of idiopathic dis- 
ease, yet we often meet with cases where the difficulty 
constitutes the only perceptible ailment. Headache may 
be caused by a preternatural determination of blood to 
the brain, by the too frequent use of intoxicating liquors, 
by a disordered condition of the stomach and bowels, by 
a loss of balance between the venous and arterial circula- 
tion, by an injudicious use of tea and coffee, undue mental 
or bodily exertion, imperfect menstruation, and the too 
frequent use of purgative medicines. It is also a symp- 
tom of most Idiopathic fevers, as well as most other acute 
diseases. 

TREATMENT. 

When headache is dependent upon over-exertion of the 
mind or body, add one-half grain of Belladonna to one- 
half tumbler full of water, and give one teaspoonful every 
fifteen minutes, until the pain ceases. If dependent upon 
constipation of the bowels, mix one ounce of neutralizing 
mixture and one grain of Podophyllin, and take one or 
two teaspoonfuls a-day, or a quantity sufficient to keep 
the bowels in a soluble condition. If upon imperfect 
menstruation : 

R Macrotin » gr. vj. 

Vallet's ferruginous mass gr. xxx. 

Mix, make twelve pills, and take one every night. Where 
the headache depends upon eating and drinking more 
than nature requires, this should be carefully corrected. 



CONVULSIONS. 221 



CONVULSIONS IN ADULTS AND CHILDREN. 

When convulsions occur in adolescence, it may indicate 
inflammation of the brain, plethora, or anserhia, ossifica- 
tion of the arteries of the brain, growth of tumors on the 
inner table of the skull, &c. When they occur in chil- 
dren, although frequently arising from disease of the 
brain and spinal marrow, they are nevertheless produced, 
in a great majority of cases, from irritation, transmitted 
to these parts, from the digestive organs. 

TREATMENT. 

When the disease occurs in adults, the treatment de- 
pends principally upo.n the cause. Although during the 
convulsions, small doses of equal parts of the Tinct, of 
Lobelia and Scutellaria, should.be frequently administered 
into the stomach, if practicable ; otherwise mixed with 
starch water, and given in the form of an enema. The 
circulation should be equalized by hot baths, sinapisms to 
the calves of the legs, feet, &c. 

When thus relieved, the patient should be treated ac- 
cording to the cause. Where children are seized with 
convulsions, the first object should be to evacuate the 
stomach and bowels. For this purpose, four or five drops 
of the compound Tinct. of Lobelia should be given, every 
five or ten minutes, until the stomach is thoroughly evacu- 
ated. At the same time, the bowels should be injected 
with equal parts of warm water, oil of olives, and molasses. 
The child should be placed in a warm bath during the 
action of the emetic and injection. When the child has 
been relieved by the above course, all irritating food 
should be carefully avoided, and a weak tea of Hydrastin 
and ginger, well sweetened, should be given occasionally 
for the purpose of giving tone to the stomach. 
19* 



222 NEURALGIA. 



NEURALGIA. 



Neuralgia has alternately been classified under the head 
of surgical and medical disease. But from the almost 
universal failure of surgical practice to relieve it, this dis- 
ease is now almost generally treated as belonging to the 
medical department. 

There is yet, however, some difference of opinion with 
respect to its pathology. Prof. Jones and others regard 
it as but a form of ague ; while Craigie and others con- 
sider it to have its seat in an inflammation of the neurilema 
or covering of the nerve. Dr. Mcintosh states that the 
cause of this disease may frequently be traced to a dis- 
ordered state of the stomach, and alimentary canal. Dr. 
Elliotson in the 3d volume of the Cyclopedia of practical 
medicine, p. 388, states that the nature of neuralgic affec- 
tions may be evident immediately, or, not till after a 
lapse of time ; may become evident after death only, 
or, may never be discovered. He further states that 
inflammatory conditions of the nerves, and structural 
changes, as well as mechanical causes, may be detected 
during life, if the seat of these conditions is within the 
reach of observation; and symptoms may be induced, 
which clearly point out the inflammation or structural 
changes, even if those should be beyond our observation. 

Occasionally, however, the seat and cause of the irrita- 
tion is not only beyond our reach during life, though dis- 
coverable afterwards, but no symptoms are produced which 
indicate them. From the above remarks, and many other 
observations which might be made, we perceive that quite 
a diversity of opinion exists relative to its pathology. In 
order to harmonize the conflicting theories, resulting as 
they do from actual observation, we might conclude that 
occasionally it has its origin in inflammation of the mem- 
branes of the nerves, in spinal irritation, in derangement 



NEURALGIA, 223 

of the stomach and bowels, and in affections of the kidneys ; 
also, that it frequently arises as one of the effects of miasm, 
and assumes a disguised remittent character. 

SYMPTOMS. 

In the most aggravated form the pain is lancinating or 
tearing, as the patient expresses it. It is sharper at some 
times than others, and in some instances the parts become 
red, and assume the appearance of inflammation, although 
this is not generally the case. When this disease attacks 
the nerves of the face, it is called Tic Doloareux. 

All the soft tissues seem to be liable to this affection. 
The attacks are mostly sudden, and last from a few hours 
to several days. The constitutional symptoms connected 
with them are frequently very slight, although, in some 
cases, the pulse becomes quick, the urine scanty and high- 
colored ; a light brown coat will appear on the tongue, 
and there will be alternate fever and perspiration. In other 
cases the paroxysms will commence with rigors and chills, 
followed by fever and perspiration ; in short, manifesting 
all the essential symptoms of ague. 

TREATMENT. 

As shis disease is decidedly of an intermittent character, 
where there is no obvious organic lesion or perceptible 
cause of the disease, the treatment should be commenced 
by giving full doses of antiperiodics, such as the following : 

U Scutellarin gr. x. 

Gypripedin gr. v. 

Quinine gr. x. 

Prussiate of Iron gr. xij. 

Mix, triturate, divide into ten powders, and give one every 
two hours, till all are taken. At the same time the affected 
parts should be thoroughly bathed in a strong, hot solution 



224 HYSTERIA. 

of Ferrocyanide of Potassium. These applications should 
be made in the form of fomentations, and changed as often 
as cold. When the antiperiodic powders are all taken, the 
bowels should be thoroughly evacuated by the use of anti- 
bilious physic and Leptandrin. If the above prescription 
be not sufficient to remove" the disease, give, the following : 
R Tinct. of Gelseminum gij. 

" Macrotys Kacemosa ....... gj. 

" Iodine £ss. 

Mix, and give three drops every three hours, until the 
symptoms yield. If there should be a tendency to a peri- 
odic return of the disease, the antiperiodic powders should 
be repeated from time to time. The bowels should be kept 
in a natural condition by the use of Neutralizing mixture, 
and as often as once or twice a week, the surface should be 
thoroughly bathed. Where the disease is dependent upon 
spinal irritation, in addition to the above mentioned causes, 
an irritating plaster should be placed along the spine, and 
remain until a free discharge ensues. Where there is de- 
rangement of the menses, Senecine and Bebeerine should 
also be used as circumstances seem to indicate. 



HYSTERIA. 

This is a disease of the nervous system, and almost 
wholly confined to females, although it is said that males 
are not exempt from it. The invasion of the disease is 
sudden and irregular, but in many cases decidedly periodi- 
cal. In slight attacks the patient bursts into a fit of weep- 
ing, soon followed by convulsive laughter, which lasts for 
a longer or shorter time, and may be followed by compa- 
rative composure. 

In more severe cases, the complaint is ushered" in by a 
sharp pain in the abdomen or chest, which is soon followed 



HYSTERIA. 225 

by a sense of suffocation and oppression at the Epigastrium. 
The bowels are tense and the surface is cold. The coun- 
tenance varies ; in some cases it is red and swollen, in 
others it is pale, and the features are contracted. In 
some very severe cases, there is a convulsive affection of 
the muscles, amounting to clonic spasms. The urine is 
mostly discharged in large quantities, and has a light 
limpid appearance. 

CAUSES, 

We seldom meet with this disease before puberty, or 
after the period of life when menstruation finally ceases, 
and as it mostly makes its appearance during the cata- 
menial flow, it is supposed to have its origin mostly in 
deranged uterine action, 

TREATMENT. 

During the paroxysms, the feet should be placed in warm 
water, and a hot sinapism applied to the lower part of the 
abdomen. The patient should take equal parts of Cypri- 
pedin and Scutellarin, one grain every half hour until the 
paroxysms subside. If the above is not sufficient to con- 
trol the disease, the compound ginger and Bayberry tea 
may be given freely, followed by ten or twenty of Beach's 
sudorific drops, or thirty or forty drops of the Tinct. of 
Castor, followed by a pill of assafcetida. After the parox- 
ysm, the patient should take from five to ten grains of 
Bebeerine, and the same amount of phosphate of Iron, 
every day for two or three weeks. 

To remove the uterine affection, Macrotin, Cauiophyllin 
and Senecin should be used, as the nature of the case 
seems to indicate. When the disease is dependent upon 
indigestion and constipation of the bowels, tonics and 
laxatives are the remedies. If upon spinal irritation, the 
proper treatment will be found under that head. 



226 MYELITIS. 

myelitis; or inflammation and irrita- 
tion OF THE SPINAL MARROW. 

The symptoms of this disease are a sharp pain up and 
down the back, rigors, fever, headache, and not unfre- 
quently delirium and coma. In some cases dysuria occurs, 
in others retention of the urine. Rigidity of the muscles 
of the back and neck is almost a constant symptom. The 
body may be bent backwards, opisthotonos, or forwards, 
emprosthotonos, or there may be a simple rigid state of 
the muscles, and the decubitis normal. In other cases 
there may be tetanus, convulsions, or paralysis. The 
muscles of deglutition are often so affected as to occasion 
much difficulty of swallowing. The pulse is mostly hard 
and quick, the bowels are extremely constipated, and 
frequently there is nausea and vomiting. The respiration 
is slow and irregular, and occasionally death is suddenly 
produced by asphyxia. 

PROGNOSIS. 

The prognosis of this disease is usually favorable under 
the eclectic system, if it receives timely treatment. 

TREATMENT. 

A sinapism should be applied along the spine, and the 
feet should be placed in warm water. The patient placed 
upon the Tinct. of Veratrum Yiride, if of a plethoric habit ; 
if otherwise, Aconite should be given, and the following 
cathartic may be administered : 

R Cream of Tartar gr. xx. 

Podophyllin gr. iij. 

Capsicum gr. x. 

Mix, triturate ; divide into six powders, and give one every 
hour until a cathartic effect is produced. The powders 



SPINAL IRRITATION. 22T 

should be assisted in their action by warm stimulating 
enema. If the disease still proves persistent, a (spirit? 
vapor bath should be given, followed by an emetic of the 
acetic tincture of Lobelia and Sanguinaria, also repeat the 
cathartic and continue the sinapism to the spine. If there 
should be muscular spasms, give the fluid extract of 
Lobelia. Cypripedin and Scutellaria, equal parts, from 
five to ten drops every half hour until that symptom sub- 
sides. After the active stage of the disease is passed, to 
prevent disorganization of the spinal marrow and its 
membranes, with 'its consequences, such as paralysis, &c, 
a full antiperiodic course of medicine should be given, 
followed by two or three drops of the Tinct. of Phos- 
phorus once or twice a day. The bowels should be kept 
open, and the system supported by the liberal use of 
Hvdrastin and Euonvmine. 



SPIXAL IRRITATION. 

This affection might be more properly designated as 
chronic inflammation of the spinal marrow, and its mem- 
branes. In fact the various morbid changes observable 
as the symptoms of what is usually designated spinal 
irritation, such as softening, effusion, hypertrophy, &c, 
all clearly indicate the previous existence of a latent 
inflammatory process. 

S Y M P T M S . 

Says Prof. J. G. Jones : "The proteian manifestations 
of spinal irritation, and the great liability that exists to 
mistake some of the numerous disturbances produced by 
disease seated in the spinal nerves, for other and more 
serious organic affections, remote from the source of trouble, 
renders the consideration of this subject scarcely less im- 
portant to the student of medicine, than that of any other 



228 SPINAL IRRITATION. 

topic connected with disease. Scarcely an organ in the 
body can be found that is not by turns made the scapegoat 
upon which these great nervous centres play off their fan- 
tastic representations of serious organic or functional dis- 
turbances, and thereby mislead the unsuspecting attendant, 
at the expense to the patient, of a severe course of 
medication directed to disease having its real seat far 
remote from the organ manifesting embarrassment and 
functional disturbance. " It will be perceived by these 
remarks of Prof. Jones, that irritation of the spinal 
marrow assumes a great variety of symptoms, which is 
actually the case. 

Not unfrequently females who are troubled with the 
latent form of spinal affection, exhibit symptoms of uterine 
derangement, heart disturbances, irritation of the lungs 
and bronchi, irregularity of the bowels, neuralgic pains, 
&c, succeeding each other in a rapid series of changes. 
The diagnosis must be made up, in these cases, by care- 
fully examining each organ, thus sympathetically affected, 
by itself ; and, in the absence of any serious organic dis- 
ease, together with the extreme nervousness of the patient, 
it will enable us to arrive at the true source of the 
complaint. On pressure of the spinal processes, there 
will generally be found more or less tenderness, although 
I have seen quite a number of cases of evident spinal irri- 
tation where this symptom was not present. 

TREATMENT. 

In cases of spinal irritation, the irritating plaster should 
be applied along the diseased part of the spine, and caused 
to remain until a free discharge ensues, and the following 
tonic and alterative given : 

R Phosphate of Iron gr. xxx. 

Sctttellarin « gr. xx. 

Syrup of Iodide of Potassium gijj. 

Port Wine 6j. 



HYPOCHONDRIASIS. 220 

Mix, and give one tablespoonful three times a day. The 
surface should be bathed in warm or cold water, as indi- 
cated, twice or three times a week ; and the bowels should 
be kept regular by the use of small doses of Neutralizing 
mixture. TThen the above course has been pursued for 
some time, and the disease is not removed, the following 
compound may be given : 

U Valerianate of Quinine gr. xx. 

Cypripedin gr. x. 

Sanguinarin gr. xx. 

White Sugar ., gss. 

Mix, triturate, and give ten grains four or five times a day. 
Also, bathe the surface in a warm solution of Ferrocyanide 
of Potassium every morning. If there is Leucorrhcea con- 
nected with the spinal difficulty, Macrotin and Caulophyl- 
lin should be given in addition to the above. 



HYPOCHONDRIASIS. 

The symptoms of this disease are exceedingly various, 
and are both imaginary and real. The imaginary ones are 
numerous, such as want of sleep, constipation of the bowels, 
inability to sleep, &c. Nothing is more common than to 
hear the patient state that he has been unable to close his 
eyes in sleep for several nights, when the fact is that he has 
slept regularly. Or that the bowels have not moved for 
days, or even weeks, when they are perfectly regular. Or 
there may be a great variety of imaginary difficulties at 
the same time. The complaints of one individual that I 
treated for this disease will serve to illustrate the imagi- 
nary symptoms of this class of cases : The patient was a 
male about 45 years of age. He first complained of ina- 
bility to walk, and accordingly took to his bed. He was 
soon unable to speak above a whisper, and imagined he 
was laboring under an attack of acute phthisis, and, as he 
20 



230 HYPOCHONDRIASIS. 

said, had excessive dyspnoea and violent cough, although 
he neither coughed nor apparently had any difficulty of 
breathing. He also complained of an entire loss of appe- 
tite, and inability to take food, yet he ate three hearty 
meals daily. At times he thought he was about to die 
from an extensive affection of the heart ; and also, that his 
liver and kidneys were consumed. In short, he was com- 
posed of a congeries of all the ills that afflict the human 
family. He continued in this state for twelve years, only 
leaving his bed for a few minutes at a time, and then with 
great difficulty. During the whole time, he only spoke 
above a whisper, except when angry. He would then be- 
come very boisterous, and talk exceedingly loud, which in 
one or two instances lasted for several days. But when 
the fit passed off, he was as seemingly incapable of speech 
as before. On examination, no apparent disease existed 
further than the natural debility dependent upon so long 
confinement. By a proper course of mental and physical 
treatment, he soon recovered, and resumed his ordinary 
occupation, that of farming. And although it is now over 
ten years, he has enjoyed uninterrupted good health. Fe- 
males who are afflicted with this diseased condition of 
the mind, often imagine they have some severe uterine 
derangement. And frequently the medical attendant being 
as ignorant of the cause of the disease as herself, subjects 
her to a very disastrous course of medication. Another 
class of patients afflicted with hypochondriasis have, in 
addition to the imaginary symptoms, some real organic 
affections which require especial treatment. 

Hypochondriasis, no doubt, is induced by a want of 
harmonious action between the different organs of the 
brain. 

TREATMENT. 

The treatment of this malady should consist principally 
in quieting, as far as practicable, the already-excited facul- 



OPHTHALMIA. 231 

ties of the brain, and bringing other faculties into action. 
The mind should be constantly directed to other subjects 
than those to which it has been previously directed ; and 
those subjects should be sufficiently exciting to arrest his 
former meditations. The head, should be frequently show- 
ered in cold, and the body, in tepid water. He should be 
induced to take as much exercise as his enfeebled condition 
will warrant. The bowels are to be regulated by mild 
aperients, and in some cases chalybeates and vegetable 
tonics will be required. If the disease is complicated with 
organic affections, it should be treated accordingly. 



OPHTHALMIA, OR IXFLAMMATIOX OF THE 
EYES. 

The eye is one of the most delicate as well as one of the 
most complicated organs of the -body. 

Diseases of the eye have been until recently very imper- 
fectly understood. ; Thus has the patient been duped, not 
only in a pecuniary point, but too often mourns the loss 
of that inestimable organ. 

Ophthalmia is mostly described as a surgical disease, 
but considering that a large majority of cases of this class 
originate in some defect of the constitution, the propriety 
of treating upon them, in a work on practical medicine, 
will readily be perceived. 

Inflammation of the eye may be divided into external, or 
inflammation of the conjunctiva, and deep-seated, or inflam- 
mation of the other tunics, including amaurosis, which is 
frequently produced by inflammation. This disease is again 
divided into acute and chronic. 



232 CATARRHAL OPHTHALMIA. 

INFLAMMATION OF THE CONJUNCTIVA. 

The first symptom complained of, in this form of inflam- 
mation of the eye, is a sensation as if particles of sand had 
insinuated themselves beneath the lids, accompanied by 
heat, pain, and increased lachrymal secretion ; also, intole- 
rance of light. In severe cases there are headache, nausea, 
constipation of the bowels, anorexia, and more or less 
disposition to fever. The causes of this form of Ophthal- 
mia are mostly local — as particles of sand, dust, or insects 
beneath the lids, inversion of eyelashes, &c. 

TREATMENT. 

The first object should be to remove the cause. If there 
is an irritating substance beneath the lid, the eye should be 
thoroughly bathed in cold Water while the lid is held open. 
If the substance is not removed in this manner, a vial cork 
should be rubbed perfectly smooth with a dry flannel : the 
particle may then be removed by touching it lightly with 
the cork. Particles of iron or steel may be removed in 
this manner; also, by means of a small magnet. When 
the eye is thus relieved, it may be packed in cold water, 
and the patient's bowels moved by a dose of anti-bilious 
physic. If the injury be sufficient to cause inflammation 
of the eye, a mild diet may be adopted for a few days, and 
the packs changed as often as necessary to keep them cool. 



CATARRHAL OPHTHALMIA. 

SYMPTOMS. 

After exposure to cold, the eyes are noticed to have a 
smarting or burning sensation, and the capillaries to be 
sufficiently dilated to admit of the red corpuscles, whereas 



CATARRHAL OPHTHALMIA. 233 

in a normal condition they only convey white ones. The 
dilated capillaries at first exhibit a radiated appearance, 
but soon become confluent, and the entire conjunctiva 
assumes a red and highly inflamed aspect. This con- 
dition of the eye is accompanied by chilliness, aching of the 
•bones, and some degree of fever. There is also intolerance 
to light, and, when the disease has become established, a 
puriform discharge from the eyes. 

TREATMENT. 

As this form of inflammation of the eye is dependent 
upon exposure to cold ; in other words, upon a contracted 
state of the superficial capillaries, and consequent con- 
gestion, or inflammation, of the deep capillaries, — the first 
indication of treatment is to relax the vessels of the surface, 
and thus unload the congested internal vessels. To effect 
this the surface should be thoroughly bathed in warm lye 
water, the patient placed in bed, and the following emetic 
given : 

B Lobelia seed, pulverized gr. xx. 

Ginger Tea Oj. 

Add the Lobelia to the ginger tea while warm, and give 
one wine-glass full every fifteen minutes, until a thorough 
emetic effect is produced. The bowels should be opened 
by the liberal use of antibilious physic. During the action 
of the emetic and cathartic, the eyes should be kept packed 
in cold, soft water. If the disease has assumed a chronic 
form, the pack should be applied as warm as the patient 
will bear it, and an astringent wash used once or twice 
a day, such as one gr. of nitrate of silver added to one oz. 
of pure soft water, and a small quantity applied to the eye 
by means of a camel's hair pencil once or twice a-day ; or 
the eye may be bathed in a strong decoction of Hydrastin 
every morning and evening. All irritating salves and eye- 
washes should be carefully avoided, as they always prove 
20* 



234 INFLAMMATION OV THE EYES. 

injurious. If there should be fever, it should be con- 
trolled by the use of Aconite. The diet should be cool 
and bland, the eye precluded from light, and the. patient 
kept quiet. 



INFLAMMATION OF THE EYES OF INFANTS, 
OR PURULENT OPHTHALMIA. 

SYMPTOMS. 

The symptoms of purulent ophthalmia of children, are 
somewhat similar to those of catarrhal ophthalmia of 
adults. The eyes are kept constantly closed, the lids are 
red and swollen, and glued together by thick puriform 
matter becoming dry. The skin will be dry, and the 
bowels irregular. If this disease is neglected, it will 
result in ulceration of the cornea and loss of the organ. 
The cause of this disease is exposure to cold, damp cloth- 
ing, and injuries in washing the child ; also the introduc- 
tion of acrid matter, which is upon the child, into the eye. 

TREATMENT. 

In the treatment of this affection, the eyes should be 
thoroughly bathed in a cold, w r eak solution of Hydrastin, 
four or five times a-day. They should be kept packed in 
cold soft water, to which is added a small amount of the 
Tinct. of Lobelia. The bowels should be kept open by the 
use of neutralizing mixture and Leptandrin, and from one- 
half to one drop of Aconite, given every four or five 
hours. Where the eye-lids become granulated, they 
should be inverted, and lightly touched with a camel's 
hair pencil, moistened with a solution of vegetable caustic, 
once or twice a-day ; but much care should be taken that 
the caustic be all removed before the lids are closed. All 
poultices should be avoided. Where the disease is of a 



AMAUROSIS. 235 

scrofulous character, either iu children or adults, Muriated 
Tinct. of Iron, Compound Syrup of Stillingia, Hydrastin, 
Scrophularia, Quinine, Iodide of Potassium, Iodide of 
Iron, and a generous diet, are the remedies. 



AMAUROSIS. 

The term amaurosis is used to denote a partial or total 
loss of vision, affecting one or both eyes. The causes of 
this affection are various. It may arise from the inflam- 
mation of the sclerotic coat, from inflammation of the iris, 
from inflammation of the retina, by congestion of the 
vessels of the retina, by congestion of the brain, by effu- 
sion into the base of the brain, by the too free use of 
ardent spirits, by gastro-intestinal irritation, by tubercu- 
lous affection of the optic nerve, by spermatorrhea, in- 
ternal use of mercury, exposure of the eye to too strong 
light, &c. 

SYMPTOMS. 

The symptoms of amaurosis very much depend upon 
the cause. Yet the following may be enumerated as 
generally present in cases of this kind : imperfect vision, 
pain in the eye, flashes of light, dark spots appearing 
before the eyes, and in some cases the pupil will be ob- 
viously dilated. The disease is mostly insidious, and its 
progress very slovr, although in some cases it is rapid, 
destroying the vision almost at once. 

TREATMENT. 

If amaurosis is dependent upon any of the inflammatory 
affections, a thorough purgative should be given at once. 
As, 

B Podophyllin gr. iij. 

Jalapin gr. j. 

Cream of Tartar gr. xxx. 



236 AMAUROSIS. 

Mix, divide into eight powders, and take one very hour 
until it operates. After which the patient should be put 
upon full doses of Tinct. of Teratrum, the pulse main- 
tained at about fifty-five or sixty beats per minute, and 
the following diuretic or alterative given : 

IJ Syrup of Marshmallow Oss. 

" Iodide of Potassium... gij. 

Mix ; dose, one teaspoonful three or four times a-day. 
The eye should be kept constantly packed with cold water, 
the diet should be low, and the patient should avoid all 
exposure of the eyes to the light, and all mental and 
physical labor. If effusion of lymph has taken place 
wkhin the tunics of the optic nerve ; or any part of the 
eye, causing amaurosis, absorption can be produced by 
the following pill : 

R Xanthoxylin gr. xx. 

Iridin gr. x. 

Podophyllin gr. iij. 

Iodide of Potassium gr. xxx. 

Ext. of Dandelion, in quantity sufficient 
to make a pill mass. 

Make three-grain pills, and let three to six be taken per 
day. At the same time, the kidneys should be stimulated 
by the use of Cream of Tartar water and vegetable diu- 
retics, as Queen of the Meadow, &c. Where there is 
loss of power in the nerve, bathing the forehead in strong 
Tinct. of Capsicum, three or four times a-day, will be 
very beneficial. The eyes should be well protected from 
strong light, and from three to five drops of Tct. Rhus 
Radicans given three times a day. If this remedy should 
fail to give relief in the course of a few weeks, the follow- 
ing mixture should be given : 

R Hydrocyanic Acid gtt. viij. 

Quinine Sul.ph gr. xx. 

Aqua giij. 



DISEASES OF THE SKIN. 231 

Mix ; dose, one teaspoonful four or five times a day. The 
bowels should be kept open by the occasional use of a 
stimulating purgative. Cold baths should be taken as 
often as every third day. Where the disease is of long 
standing, indicating paralysis of the optic nerve, the fol- 
lowing may be used to advantage : 

R Extract Macrotys gr. xx. 

" Mux Vomica gr, x. 

" Euonymine gr. xxx. 

Mix, and form a pill mass, and make two-grain pills. 
Dose, from one to three pills, three times a day. During 
the entire course of treatment, the anterior portion of the 
head should be frequently bathed with a stimulating pre- 
paration. 

i 

DISEASES OP THE SKIN. 

HERPES, OR SALT RHEUM. 

SYMPTOMS. 

Small vesicles grouped together upon inflamed patches 
of skin ; the vesicles contain a thin, light, transparent 
fluid, which is absorbed or evaporated, leaving a thin 
transparent scale. This desiccation will desquamate and 
leave the part, which will again become affected in the 
same manner. There are two other varieties of Herpes 
spoken of by writers, viz : Herpes Zoster or Shingles, and 
Herpes Circinatus or Ring-worm. The symptoms of 
Herpes Zoster are full and quick pulse, dry skin with 
fever, tenderness of the Epigastrium, constipation of the 
bowels ; and the herpetic eruption which generally com- 
mences on the bowels, and spreading frequently, encircles 
the body. The appearance of the eruption, is almost 
identical with salt rheum : it is in fact the acute form of 



238 DISEASES OF THE SKIN. 

it. The symptoms of Herpes Circinatus are very simple ; 
it being only what is known as a ring-worm, no farther 
description will be required. 

TREATMENT. 

As an external application, an ointment may be used 
made as follows : 

R Iodide of Zinc gr. xxx. 

Ext. of Phytolocca Decandra gr. xx. 

" Black Walnut Bark gr. xxx. 

" Balsam Copaiba §ij. 

Mix, and rub a small portion on the diseased part, morn- 
ing and evening. Previously, the part should be well 
bathed in a strong decoction of Black "Walnut buds or 
leaves. At the same time, the following compound should 
be taken internally : 

R Juglandin 3J. 

Irisin gss. 

Sac Alba , giij. 

Mix, triturate, and give from ten to fifteen grains twice a 
day. Also give one teaspoonful of compound syrup of 
Stillingia three times a day. If there is tenderness in the 
parts after the disease seems to be removed, they should 
be protected by liquid collodion for a few months, to 
prevent a return. For Herpes Circinatus, or ring- worm, 
wash the parts m Saleratus water, and cover with Col- 
lodion. 

In Herpes Zoster, or Shingles, the eruptive surface 
should be well bathed in a strong solution of zinc, after 
which apply a slippery elm poultice. A purgative of 
Juglandin and Cream of Tartar should be given, and 
repeated from time to time as long as the disease proves 
active. To control the fever, Aconite or Veratrum should 
be used, and the surface frequently bathed in lye water. 
If the disease is periodical, some of the antiperiodic medi- 



ECZEMA. 239 

cines should be given. The zinc wash should be repeated 
from time to time, until the active inflammation is sub- 
dued. Afterwards use the liquid Collodion instead. 

ECZEMA. 

This is another form of herpetic eruptive disease, and 
like all others, it is characterized by small blisters or 
vesicles. There are several varieties of this form of erup- 
tive disease, such as Eczema of the face, or crusta lactea, 
Impetigo, or moist tetter, &c. The causes of these cu- 
taneous eruptive diseases are as numerous as the varieties. 
They may arise from improper diet, exposure to cold, 
teething in children, intestinal irritations, &c. They are 
also, hereditary. The symptoms depend very much upon 
the cause ; but in ail cases, where the disease is in any 
way severe, there is more or less constitutional disturb- 
ance, such as irregularity of the bowels, fever, quick 
pulse, scanty and high-colored urine, &c. The limits of 
this work will not allow of a minute description, of every 
form, of these eruptive diseases and their symptoms. But 
as the treatment varies only, as the causes are different, 
the descriptions and symptoms given will be found suffi- 
ciently minute for all practical purposes. 

TREATMENT. 

There is no class of remedies more efficacious in skin 
diseases, than the preparations of the Juglans cinerea ; 
and the most efficient of these is the Juglandin. This 
should be used in connection with bi tartrate of potassa, in 
sufficient quantities to produce a mild purgative effect. 
The best preparation of that kind is the following : 

R Juglandin gr. xxx. 

Cream of Tartar gr. xxx. 

Pulv. Cubebs gr. xx. 



240 ITCH. 

Mix, triturate, and divide into twenty powders, and give 
one every morning and evening. 

The above may be given in connection with, or alter- 
nated with antiscrofulous syrup; or Iodide of Potassium. 
In some cases, iron and antiperiodics will be required. 
The external applications should be tar ointment, nitro- 
muriatic acid, zinc ointment, ointment of Baptism, acetic 
Tinct. of Bloodroot, astringent washes, slippery elm poul- 
tices, and Collodion. These different remedies may be 
used as the nature and character of the disease seem to 
indicate. In the active stage, the preparations of zinc 
are the best adapted to remove the disease, while the 
others are more efficient in the chronic stages. 

ITCH, OR SCABIES. 
This disease is caused by minute white insects, the 
Acarus Scabiei, or Sareoptis hominis, which insinuate 
themselves beneath the cuticle, and travel over the differ- 
ent portions of the rete mucosum. It is said that these 
insects travel in pairs — male and female — and that the 
female is very much smaller. By the aid of the micro- 
scope, they are observed to have a large number of bristles 
upon the head or proboscis. When they find a soft and 
moist portion of skin, they burrow beneath a small der- 
moid scale, and luxuriate until a deposition of a small 
quantity of serum from the blood warns them, that unless 
they take their departure, a flood will soon overtake them. 
But before taking their final leave, the female deposits her 
eggs at the point of the vesicle ; thus a nidus is formed 
for the complete development of the acarii. 

SYMPTOMS. 

A vesicular eruption makes its appearance between the 
fingers, and in other soft portions of the skin, accompanied 
by an intolerable itching. If the vesicle is opened, a 
small amount of sero-albuminous matter will escape, and 
if allowed to dry, will form a light brown scale. 



PUSTULOUS CUTANEOUS. 241 
TREAT MEN T . 

The only remedy necessary in the treatment o;' this 
disease is sulphur, and the reason why this remedy is 
not more successful, is the inefficiency of its applica- 
tion. The entire surface of the patient should first be 
washed with soap and water ; immediately afterwards, 
a strong decoction of sulphur should be applied to every 
portion of the body, and allowed to remain from one-half 
hour to an hour, when the whole surface should be wiped 
with a towel, wrung out of strong saleratus water. One 
application of the sulphur, used as directed above, will 
generally remove the disease : yet, it is advisable to renew 
the application several times. The sulphur, on coming in 
contact with the insect, immediately destroys it, 

PUSTULOUS CUTANEOUS DISEASE. 

All the diseases characterized by pustules, may be cor- 
rectly classified under the above head. Willan and Bate- 
man specify four varieties of this form of non-contagious 
disease, viz : phlyzacium, psydracium, achor, and favus. 

SYMPTOMS. 

A greater or less number of distinct tumefied eruptions, 
which gradually mature and become filled with a sero- 
purulent matter, and having an inflamed base. These 
may appear in small clusters, and disappear in a few days, 
or they may cover a considerable part of the hands, face, 
or other portions of the body, and be accompanied with 
extensive inflammation of the integument, and extending 
in some instances to the adjacent tissues, terminating in 
phlegmonoid abscess. Nearly all the forms of tetter come 
under this class, as do also impetigo and acne. In some 
cases, there are constitutional symptoms, as fever, quick 
21 



242 PUSTULOUS CUTxlNEOUS. 

pulse, headache, loss of appetite, &c. The causes of this 
kiud of cutaneous disease, are essentially the same as of 
the vesicular, but they are more apt to be connected with 
an impoverished condition of the blood. 

TREATMENT. 

If this disease appears on the head, it is called porrigo, 
or scald head. The hair should be shaved close to the 
scalp, and the head must be thoroughly washed with soap 
and water, after which the zinc and tar ointment must be 
alternately applied, morning and evening — the zinc in the 
morning, and the tar in the evening : the patient should 
likewise take a full dose of the alterative syrup three times 
a day. This course, if persisted in, will remove the dis- 
ease. When the eruption appears on other parts of the 
body, the nitro-muriatic acid should be first applied, and 
be followed by the Tar ointment. A mild purgative of 
Juglandin and Cream of Tartar, also simple syrup of 
Stillingia and Scrophularia, equal parts, should be taken 
in small quantities during the application of the external 
remedies. When the pustular eruption is connected with 
extensive inflammation of the skin, a slippery elm poultice 
should follow the application of the ointment. Should the 
disease prove obstinate, equal parts of vegetable caustic 
and pulverized Sanguinaria, should be sprinkled over the 
parts before each application of the ointment. If there 
are constitutional symptoms, they should be treated accord- 
ing to their nature ; in most cases, iron and vegetable 
tonics will be required. The diet should be nutritious, 
and the surface freely bathed once or twice a day. To 
remove the small pustules which appear on the face, apply 
a liniment made of equal parts of ammonia and sweet oil. 
Or, when they first appear, touch them with ammonia, and 
cover them with Collodion. 



PURPURA. * 243 



PURPURA. 

There are several varieties of this disease : as simplex, 
or petechial scurvy, purpura hemorrhagica, purpura 
nautica, purpura scarlatina. By the term purpura, we 
understand a greater or less number of livid spots on the 
skin from extravasated blood. In purpura simplex, the 
effusion is confined to the skin and cellular tissue, mostly 
occurring on the arms, legs, and breasts. The spots at 
first are small, resembling flea-bites, and are frequently 
very numerous. The countenance is pale, and the patient 
complains of great debility, loss of appetite, irregularity 
of the bowels, and periodic fever. If the disease is al- 
lowed to progress, it will terminate in what is called pur- 
pura hemorrhagica, and is described by Dr. Bateman as 
follows : 

"The petechias are often of a large size, and are inter- 
spersed with vibices, echymoses, or livid stripes and 
patches, resembling the marks left by the strokes of a 
whip, or violent bruises. They commonly appear first on 
the legs, and at uncertain periods afterwards, on the 
thighs, arms, and trunk of the body ; the hands being 
more rarely spotted with them, and the face generally free. 
They are usually of a bright red color when they first 
appear, but soon become purple or livid ; and when about 
to disappear, they change to a brown or yellowish hue ; 
so that, as new eruptions arise, and the absorption of the 
old ones slowly proceeds, this variety of colors is com- 
monly seen in the different spots at the same time. The 
cuticle over them appears smooth and "shining, but it is 
not sensibly elevated ; in a few cases, however, the cuticle 
has been seen raised into a sort of vesicles, containing 
black blood. This more frequently happens in the spots, 
which appear on the tongue, gums, palate, and inside of 
the cheeks and lips, where the cuticle is extremely thin, 



244 * PURPURA. 

and breaks from the slightest force, discharging the effused 
blood. The gentlest pressure on the skin, even such as is 
applied in feeling the pulse, will often produce a purple 
blotch, like that which is left after a severe bruise. The 
same state of the system which gives rise to these effusions 
under the cuticle, produces likewise copious discharges of 
blood, especially from the internal parts, which are de- 
fended by more delicate coverings. These hemorrhages 
are often very profuse and not easily restrained, and there- 
fore sometimes prove suddenly fatal ; but in other cases, 
they are less copious ; sometimes returning every day at 
stated periods, and sometimes less frequently, and at 
irregular intervals ; and sometimes there is a slow and 
almost incessant oozing of blood. The bleeding occurs 
from the gums, nostrils, throat, inside of the cheeks, 
tongue, lips, and sometimes from the lining membrane of 
the eyelids, the urethra and the external ear ; and also 
from the internal cavities of the lungs, stomach, bowels, 
uterus, kidneys, and bladder. There is the greatest 
variety, however, in different instances as to the period of 
the disease, in which the haemorrhages commence and 
cease, and as to the proportion which they bear to the 
cutaneous efflorescence. 

"This singular disease is often preceded, for some 
weeks, by great lassitude, faintness, and pains in the 
limbs, which render the patient incapable of any exertion ; 
but, not unfrequently, it appears suddenly in the midst of 
apparent good health. It is* always accompanied by 
great debility and depression of spirits ; the pulse is some- 
times quickened ; and heat, flushing, perspiration, and 
other symptoms of febrile irritation, recurring like the 
paroxysms of hectic, occasionally attend. In some 
patients, deep-seated pains have been felt about the pre- 
cordia, and in the chest, loins, and abdomen ; and in 
others, a considerable cough has accompanied the com- 



PURPURA. 245 

plaint, or a tumor and tension of the epigastrium, right 
or left hypochondrium, with tenderness on pressure, and a 
constipated, or irregular state of the bowels. Bat in 
many cases, no febrile appearances have been noticed ; and 
the functions of the intestines are often natural. In a 
few cases, frequent syncope has occurred. When the dis- 
ease has continued for some time, the patient becomes 
sallow, or of a dirty complexion, with much emaciation, 
and some degree of oedema appears in the lower extremi- 
ties, which afterwards extends to other parts. The disease 
is extremely uncertain in its duration ; in some instances 
it has terminated in a few days, while in others it has con- 
tinued not only for many months, but even for years." 

When the disease runs a rapid course and terminates in 
death, it is generally dependent upon the occurrence of 
hemorrhage into some of the vital organs. Such is the 
disposition to hemorrhage in this stage of the disease, that 
although a patient may appear convalescent on retiring to 
bed in the evening, he may be suddenly seized with violent 
dyspnoea and orthopnoea, which rapidly increases until 
death ensues by asphyxia. In such a case, there has been 
a sudden effusion of blood into the pulmonary tissue, pro- 
ducing pulmonary apoplexy. 

Or there may be acute haemoptysis, caused by the escape 
of blood into the air passages. In this event, the hemor- 
rhage may be controlled, and the patient recover under 
proper treatment. The hemorrhage may occur in other 
organs, as the brain, producing apoplexy and death ; or, 
into the cavities of the chest and abdomen. It also 
occurs into the cellular tissue, producing extensive eeclrv- 
niosis, inflammation, gangrene, and death ; or the purple 
spot will gradually assume a yellow appearance, absorp- 
tion of the effused blood occur, and the patient recover. 

In purpura nautica, the purple spot mostly occurs at 
the roots of the hair, on the gums, and mucous membrane 
21* 



246 PURPURA. 

of the mouth and pharynx. In this form of the disease, 
the gums become spongy and bleed upon the slightest 
injury, the teeth become loose, and frequently fall from the 
gums : there is great debility, a sallow countenance, ir- 
regular sleep, and night-sweats, followed by fever ; the 
bowels are irritable, and there is mselena. This latter 
form of it, Prof. J. GL Jones has treated as a separate 
disease, under the head of Scurvy or Scorbutus ; and con- 
siders it the same as various writers have described as sea- 
scurvy : although he does not favor the opinion, at one 
time very prevalent, that salt water causes the disease ; but 
states, that the cause is generally more of a positive 
than a negative character, being the want of such articles 
of food as furnish the system through the medium of the 
blood, with certain elements indispensable to life and 
health. He is of the opinion that these deficiencies con- 
sist in the lack of vegetable acids. 

On comparing the description of scurvy by Prof. Jones, 
Mcintosh, Bateman, and others, with purpura, as it is 
described by various individuals, the only difference be- 
tween what is known as sea-scurvy, and purpura, is the 
circumstances under which it makes its appearance ; both 
evidently depend upon the same pathological condition of 
the system. 

CAUSE. 

The causes of the different varieties of this disease, 
seem to depend upon a deficiency of vegetable aliment, 
and long exposure to a damp atmosphere ; also, a lack of 
due exercise, an unwholesome diet, and anything which 
tends to an impoverished state of the blood. The influ- 
ence of improper diet, in developing purpura, has been 
remarkably exemplified within the past year. Owing to 
the failure of fruit, as well as the potato crop and other 
vegetables, bread, butter, and meats have been the princi- 
pal articles of diet ; and purpura, which was hardly known 



PURPURA, 247 

in the country, has become a prevalent disease. So 
much so, that the most trifling complaints are attended 
frequently by active hemorrhage. On examining the 
blood, it is found to be deficient in fibrine, but feebly 
disposed to coagulate, and very abundant in serum. 

TREAT 31 E NT. 

When the disease first makes its appearance in the 
simple form, little more is necessary than a liberal diet of 
fresh vegetables, with out-door exercise, and a small 
amount of Muriated Tinct. of Iron, say from five to ten 
drops three times a day. "Where the disease assumes a 
hemorrhagic character, the following may be given : 

U Quinine gr. xv. 

Citrate of Iron gr. xxx. 

Capsicum gr. xx. 

Mix, triturate, divide into eleven, powders, and take one 
every three hours. The patient should at 'the same time 
make a free use of lemonade, and take a free diet of green 
vegetables, salt meats, eggs, &c. After the powders are 
all taken, the following mixture should be given : 

R Port Wine Oj. 

Phosphate of Lime , gss. 

Carbonate of Iron giij. 

Mix, shake well, and take one tablespoonful, three or four 
times a day. If effusion has occurred into the cellular 
tissue of one of the limbs, it should be carefully ban- 
daged, and kept constantly wet in a strong liniment of 
camphor, whiskey, and spirits of turpentine. The bowels 
should be moved once or twice a week, by the use of 
Antibilious physic and Cream of Tartar. The body 
should be frequently bathed in warm or cold water as 
indicated. 

Should hemorrhage occur into the bowels, lungs, or any 
other organ, the oil of Erigeron may be given in five or 



248 RETENTION OF URINE. 

six drop doses every half hour. If there should be me- 
laena, and the oil of Erigeron should fail to arrest it, the 
nitrate of silver pill may be given as directed under the 
head of typhoid fever. Or from five to ten grains of 
Matico, may be given every fifteen or twenty minutes, 
until* the hemorrhage ceases. If there is much debility, 
porter, ale, or brandy, should be given in such quantities 
as the nature of the case may indicate. The patient 
should avoid all active exercise, and exposure to a damp, 
moist atmosphere ; let him repeat the Quinine and Iron 
from time to time, until the disease is removed. 



ISCHURIA, RETENTION OP URINE. 

In this disease, the urine, accumulated in the bladder, 
cannot be evacuated without extreme difficulty, or without 
assistance ; when it cannot be evacuated without assist- 
ance, the retention is said to be complete ; and when it is 
evacuated without assistance, but with great difficulty, it 
is said to be incomplete. 

CAUSES. 

The causes of retention of urine are various ; as in- 
flammation of the bladder, small stones or gravel lodging 
in the urinary passages, hard faeces lying in the rectum, 
pregnancy, stricture of the neck of the bladder, swelling 
of the hemorrhoidal veins, paralysis of the bladder, pro- 
lapsus uteri, inflammation of the mucous surface of the 
urethra ; it also occurs in female hysteria, and from in- 
flammation of the meatus urinarius. 

SYMPTOMS. 

When the bladder becomes abnormally distended with 
urine, there will be a dull pain in the back, with sharp 
lancinating pains passing through the bladder. As the 



RETENTION OF URINE. 249 

accumulation of urine goes on, the pain increases until it 
becomes excruciating, the arterial system is much excited, 
and the pulse beats with increased frequency, rising to 100 
or 140 beats per minute. The respiration is hurried, and 
the skin hot and dry. If the uric acid is allowed to be 
absorbed into the blood, the brain will sympathize with 
the other constitutional symptoms, producing delirium, 
and as I have seen in several eases, clonic spasms. Unless 
the bladder is evacuated, it will become perforated, pro- 
ducing death ; or death may occur as the result of zymotic 
influence upon the blood and nerves. 

T R E A T M E N T . 

When the retention is dependent upon inflammation of 
the bladder, kidneys, or urethra, the bladder should first 
be evacuated by means of a catheter ; after which the 
disease should be treated, as directed under the head of 
inflammation of these parts. If it depends upon a stric- 
ture, it can generally be overcome by injecting into the 
urethra, a solution of the extract of Belladonna or Gel- 
seminum : 

R Extract of Belladonna , gr. x. 

Warm "Water -iij. 

Dissolve the extract in the water, and inject one third into 
the urethra. If this is not soon followed by relief, it may 
be repeated every fifteen or twenty minutes. If, in a 
reasonable time, relief is not effected, the Ext. Gelseminum 
be used in the same manner. In my hands this treat- 
ment in strictures of the urethra has proved efficacious in 
a large number of eases. TVhere the disease is occasioned 
by a gravelly deposit in the bladder, 

U Ext. Eupurpurin gr. xxx. 

Cre;vm of Tartar 3J. 

Apocynin gr. xx. 



250 INCONTINENCE OF URINE. 

Mix, triturate ; divide into ten powders, and give one 
three times a day in one teaspoonful of Syrup of Iodide of 
Potassium ; the hypogastric and lumbar regions should be 
bathed every morning and evening in equal parts of sweet 
oil and spirits of turpentine. Where there is pressure on 
the neck of the bladder, by faeces lying in the rectum, by 
pregnancy, or other cause, it should be removed. And 
then, by the use of Marshmallow, Clivers or flaxseed tea, 
a cure may be effected. In females, where it is dependent 
upon irritation of the meatus urinarius, a warm elm poul- 
tice, applied to the vulva, and melon-seed tea, will gene- 
rally effect a cure. If there should be debility of the 
bladder, with a tendency to paralysis, tonics, combined 
with Iron, should be used, and the nerves of the back 
gently stimulated by the application of the electro-magnetic 
current once or twice a day. During the treatment of 
retention of urine, whatever the cause may be, the bladder 
should be evacuated every day by the use of the catheter. 



ENURESIS, INCONTINENCE OP URINE. 

Incontinence of urine, like retention, is often associated 
with some constitutional weakness. In advanced life it is 
usually associated with disease of the neck of the bladder, 
prostate gland, or with paralysis. Incontinence of urine, 
in children, mostly occurs in the night only, while asleep ; 
and, not unfrequently, in these cases the urine passes off 
involuntarily under the influence of a dream. 

It is said that in such cases the acid property of the 
urine is the exciting cause, and that there is a strong ten- 
dency to gravelly deposits. In young people, where the 
urine passes off in the night involuntarily, it is usually 
retained, at any time, with much difficulty, and will be of 
a very pale color, and far less serous than is natural. In 



HEMATURIA. 251 

old people, this difficulty arises from paralysis, produced 
by injuries of the spine, or over-distension of the bladder, 
injuries of the neck of the bladder, &c. 

TREATMENT. 

In children, where the disease depends upon a changed 
condition of the urine, the diet should be well regulated, 
and warm or cold baths given three or four times a week. 
A syrup of equal parts of Hydrastus Canadensis and 
Aletris Farinosa should be given in teaspoonful closes 
three times a day. Where it depends upon spinal irrita- 
tion, the irritating plaster should be applied to the spine, 
and from five to ten drops of the oil of Erigeron given 
three times a day, with a free use of cold baths and 
friction. 

If the bladder is in an irritable state, give the following : 

R Dwarf Elder gj. 

Indian Hemp ^ij. 

Marslimallows gj. 

Make one pint of syrup, and add one half pint of gin. 
Dose, one teaspoonful three times a day. If there is an 
enlarged condition of the prostate gland, one drachm of 
Iodide of Potassium should be added to the syrup, and 
the same quantity taken. 



HEMATURIA, OR HEMORRHAGE FROM THE 
TJRIXARY ORGANS. 

This frequently occurs, in certain epidemics of the 
malignant type, as in cholera and severe remittent and 
typhoid fever, in which the spleen and liver are implicated ; 
also in Purpura, Scurvy, and all diseases in which the 
blood is in an impoverished state. The exciting cause of 
hematuria may be of a mechanical nature, that is, a cal- 



252 URINARY HEMORRHAGE. 

cuius concretion ; or it may be from ulcerations of the 
bladder, kidneys, or their appendages. When the hemor- 
rhage cannot be traced to some constitutional disturbance, 
it may be considered directly mechanical. This may 
depend upon a calculus, either causing irritation or wound- 
ing some blood-vessel ; or the hemorrhage may occur from 
ulceration of the bladder, by the irritating effect of the 
urine itself. 

DIAGNOSIS. 

When the patient is laboring under no .constitutional 
disease, that is usually accompanied by hemorrhage, or has 
not been afflicted with calculous affections, if he complains 
of pain in the urinary organs, and voids blood with the 
urine, mixed with mucus, and especially if mixed with 
purulent matter, a breach of surface must exist somewhere 
in the urinary apparatus. Having ascertained the cause 
of the hemorrhage, its seat should be sought for. When 
there are sharp twisting pains along the line of the ureter, 
darting to the urethra and testicles, accompanied with 
nausea and vomiting, it may be reasonably supposed that 
it depends upon the presence of calculus in the ureter or 
kidneys. On the other hand, when the hemorrhage comes 
on after exercise, and there is occasional retention, accom- 
panied by a twinging pain in the penis, there can be but 
little doubt that the hemorrhage is caused by stone in the 
bladder. Where the hemorrhage is from the kidneys, the 
first urine that flows is generally clear, the blood mostly 
passing at the close of micturition. 

T REAT ME N T . 

The treatment of hsematuria will depend upon the 
cause, the degree and locality, 

Where the disease is dependent upon scurvy or purpura, 
it should be treated as directed under that head, with the 
addition of astringents, such as an injection of a weak 



URINARY HEMORRHAGE. 253 

solution of Matico into the bladder, and the oil of Erigerop 
taken internally. If occurring as melama, the effect of 
obstruction of the liver and spleen, give the following : 

R Muriated Tinct. of Iron gij. 

Quinine gr. xx. 

Water giij 

Mix, and give one tablespoonful every four or five hours 
until the active stage of the disease is passed. After which, 
the following mixture : 

R Gin Oj. 

Sugar lbj. 

Water Oj. 

Aletrin gj. 

Euonymine 31J. 

Mix, and give one tablespoonful three or four times a day. 
The region of the liver and spleen should be bathed two or 
three times a day in a liniment composed of sweet oil and 
spirits of turpentine. Where haematuria is connected with 
a gouty diathesis, a free purgative of Podophyllin and 
Cream of Tartar may be given in the commencement of 
the treatment, followed by full doses of the oil of Erigeron, 
until the hemorrhage ceases. After which, nitro -muriatic 
acid and Euonymine should be given. If calculus in the 
kidneys is the cause of the disease, a strong decoction of 
the Queen of the Meadow will dislodge it and arrest the 
hemorrhage ; after which, mucilaginous diuretics should 
be given, such as marshmallow, flaxseed, &c. "When the 
cause of haematuria is seated in the bladder, it should be 
injected first with warm water, afterwards with a strong 
solution of Matico mixed with starch-water. The back 
and loins being thoroughly bathed with a liniment pre- 
pared as follows : 

R Oil of Capsicum gtt. x. 

Alcohol Oss. 

Oil of Origanum ,, £iij. 

22 



254 UTERINE CONGESTION. 

Mix, and use as heretofore directed. If there is mu h 
inflammation of the bladder, scarify and cup over that re- 
gion, and apply hot packs. At the same time give Aco- 
nite or Yeratrum until the symptoms are controlled. If the 
bladder should become distended with a large amount of 
coagulated blood, recourse must be had to a large-sized 
catheter; and by the aid of an exhausting syringe and an 
occasional injection of the bladder with cold water, the 
coagula may be removed. Should the hemorrhage become 
active while thus evacuating the bladder, it may be arrested 
by injecting a solution of Matico into the rectum. 



CONGESTION AND INFLAMMATION OF THE 
UTERUS. 

This disease is but imperfectly understood; and more 
frequently than otherwise passes unobserved both by the 
patient and her medical attendant. In a great majority 
of cases it is treated by physicians as prolapsus uteri, ame- 
norrhea, dysmenorrhea, menorrhagia, or leucorrhaea ; the 
primary cause of the disease is overlooked, and the symp- 
toms only receive attention. Hence it is that but little if 
any benefit is derived from the ordinary course of medica- 
tion in this class of cases. 

The hydropathists have acquired some reputation for 
treating this class of cases, and in many instances they have 
had superior success. Their success, however, is not de- 
pendent upon a more extensive knowledge of the affections 
so much as the remedy upon which they rely being better 
adapted to relieve this peculiar pathological condition 
of the uterus, than the remedies generally- used for this 
purpose. 

Congestion of the uterus, like congestion of other organs, 
is a disease of frequent occurrence, and is caused by the 



UTERINE CONGESTION, 25o 

accumulation of blood in the veins and capillaries. The 
congestion is generally combined with infiltration into the 
cellular tissue of the uterus, producing oedema of the ute- 
rus, and in some cases the oedema is very considerable. 

SYMPTOMS, 

On making a vaginal examination of the uterus, a com- 
plete congested appearance is manifest. The uterus is 
enlarged and vesicular, and in places the veins have a 
varicose appearance. In the incipient congestion of the 
uterus the appearance very much resembles that of early 
pregnancy. The uterus is tender upon pressure, and if the 
disease is of long standing, the broad ligaments and vagina 
also present a similar congested condition. In other cases 
there is excoriating granulations, or ulceration of the neck 
of the uterus and its lining membrane. Congestion of the 
uterus, like the congestion of other similar tissues, is fol- 
lowed by pathological changes, such as an increased afflux 
of blood to the part ; a loaded condition of the capillaries, 
the blood circulating with less and less force until it finally 
ceases, and a complete barrier is formed to the further cir- 
culation of blood in the part. At this stage inflammation 
is said to commence. But where congestion assumes a 
chronic form, as it mostly does in the uterus, the vessels, 
after having been thus distended for some time, contract 
upon their own contents, forcing the more fluid portions 
of the blood out of the vessel into the adjacent areolar and 
cellular tissues ; and in this way the parenchyma of the 
uterus becomes extensively infiltrated with the fluid portion 
of the blood. Where the congestion extends to the vagina 
and inner membrane of the uterus, a similar exosmosis 
occurs from the congested capillaries of the parts ; instead 
of being retained in the parenchyma, it escapes into the 
cavity of the uterus and vagina, mixing with the mucus, 
and thus constituting what is known as the whites. In case 



256 UTERINE CONGESTION. 

the blood is anaemic, and the patient of a scrofulous cachexia, 
the salts of the blood held in solution will make their escape 
with the serum, and, mingling with mucus, cause a muco- 
purulent or muco-serous discharge. If there is abrasion 
of the uterus or its appendages, the sanious secretion from 
the ulcer, mixed with the disintegrated tissues of the parts, 
often renders the discharge not only offensive but exceed- 
ingly irritating, denuding the vagina of its mucous surface 
and inducing either an acute or chronic inflammation. The 
constitutional symptoms are a sense of weakness, weight, 
or pain in the back ; the patient complains of nervousness, 
pains in the head and shoulders, often changing to different 
parts of the body. The functions of the stomach and 
bowels become deranged ; the countenance is sallow, and 
the skin has a dry and husky appearance ; the lips lose 
their color, and the eyes their natural brilliancy; the feet 
and hands are mostly cold, although in some cases, and 
in some portions of the day, they are hot and burning. 
The menses are mostly irregular either in quantity, quality, 
or time of occurrence. I have observed all these symptoms 
in connection with congestion of the uterus. If the disease 
is allowed to advance, palpitation of the heart will occur, 
with cough, bronchial irritation and expectoration of mu- 
cus. At this stage of the disease, the increased weight of 
the uterus, together with the relaxed condition of the mus- 
cular tissue, causes the uterus to gravitate into the pelvis, 
resulting in what is usually known as prolapsus uteri. The 
lower floor of the abdominal cavity thus giving way, ena- 
bles the whole contents of the abdomen and thorax to settle 
from their normal position. The bowels, stomach, liver, 
spleen, heart, and lungs, all being thus displaced, put the 
pneumogastric nerve and upper portion of the lung upon 
a stretch, producing a constant irritation and materially 
increasing the cough, which before was considerable. If 
this condition of things is allowed to continue, the blood 



UTERINE CONGESTION. 25T 

soon becomes impoverished, owing to a defective appetite, 
irregular respiration and leucorrhaea, and a tuberculous 
deposition occurs in the lungs. In cases where the uterus 
has become impregnated, the symptoms frequently somewhat 
abate, although in several cases I have known them to be 
very much aggravated, and maintain an uncommon obsti- 
nacy during the entire stage of gestation. Where the ute- 
rus remains thus congested during pregnancy, the disease 
is very liable to terminate in inflammation immediately after 
delivery, proving very obstinate, and, unless properly 
treated, disastrous to the patient. In these cases there is 
acute pain just above the pubes, quick pulse, hot skin, and 
retention of urine, either partial or complete. The tongue 
will soon be covered with a dark brown coat, and many 
times there are convulsions. The bowels are constipated, 
and in many cases there is nausea and vomiting. 

If the disease is not controlled, delirium, coma, and 
death ensue. The inflammation may be less acute, ex- 
tending to the peritoneum, causing a tympanitic condition 
of the bowels, suppression of the lochia and milk, with 
violent fever. There are other points of great interest 
connected with this form of uterine derangement, which 
the limits of this work will not allow me to consider. 

CAUSES. 

There are a variety of causes which may produce this 
condition of the uterus ; such as the frequent use of era- 
menagogues, which contain mercury, exposure of the 
feet to the damp and cold earth by wearing thin shoes ; 
the practice of dressing in such a manner as to compress 
the waist, thus preventing the return of the venous blood 
to the heart by the superficial veins, also obstructing the 
capillary circulation ; hence the blood is forced through 
the deep capillaries, inducing congestion of the uterus. It 
may also be caused by repeated abortions, by excessive 



258 UTERINE CONGESTION. 

venery, by cold and exposure ; in short, anything which 
will induce it in any of the internal viscera, will produce 
it in the uterus. 

TREATMENT. 

In commencing the treatment of this disease, the cause 
should be constantly kept in view, and as far as possible 
be removed. To remove the congestion, a plaster should 
be applied to the abdomen over the uterus, composed of 
the following materials : 

1J Gum Galbannm gij. 

White Pine Gum , t ^j. 

White Wax gjss. 

Melt the gums and wax together, add one drachm of 
pulverized blood-root, and stir until it becomes thickened ; 
spread a coat of it upon a thin piece of leather, large 
enough to cover the uterus, and apply. It should be 
renewed from time to time until relief is effected. At the 
same time, give the following compound : 

U Gelsemin gr. ij. 

Bebeerine.... gr. xxx. 

Caulophyllin gr. x. 

White Sugar gr. xxx. 

Mix, triturate, divide into twelve powders, and give one 
every six hours. During the administration of these 
powders, vaginal injections of the cold infusion of Cin- 
chona should be used two or three times a day. During . 
the early part of the treatment, a thorough hand-bath 
should be taken every morning as indicated ; also an oc- 
casional sitz bath. The above treatment should be pur- 
sued for ten or fifteen days ; the following may then be 
substituted : 

R Carbonate of Iron gj. 

Pulv. Queen of the Meadow ,|ij. 

Cream of Tartar gj. 






UTERINE CONGESTION. 259 

Port Wine Oj. 

Sugar lbj. 

Gin Oj. 

Dose, one tablespoonful three times a day. At the same 
time: 

R Fol. Jugland Regice, or Fresh Walnut leaves. 3 v j- 
Port Wine Oj. 

Make a Tincture, and use a syringe full, as vaginal injec- 
tion, once or twice a day. The plaster should be removed, 
and a wet girdle worn around the lower portion of the 
abdomen and back. During the entire course of treat- 
ment, the bowels should be regulated by the use of neu- 
tralizing mixture. If any of the symptoms, described as 
dependent upon this disease, should remain after using the 
above remedies for a reasonable length of time : 

U Macrotin * gr. xx. 

Senecin gr. x. 

Capsicum . gr, xx. 

Vallet's Ferruginous Mass gj. 

Mix, and form a mass. Make three-grain pills, and let 
one be taken three times a day, alone, or in connection 
with other medicines as indicated. If there should be 
ulcers upon the vagina or uterus, the speculum should be 
introduced, and the vegetable caustic be applied, after 
which the ulcer should be covered with powdered slippery 
elm. Much care will be required in making this applica- 
tion, to prevent the caustic from coming in contact with 
parts not diseased. If there should be a scrofulous dia- 
thesis, connected with this disease, Stillingia and Iodide 
of Potassium may be used in connection with the other 
remedies. The diet in any case should be free and nutri- 
tious. In case the congestion should terminate in a latent 
form of inflammation, Muriated Tinct. of Iron, Yeratrum, 
Cinchonine, and Cornine, in connection with the local 
applications, as directed under the head of congestion. 



260 CESSATION OF THE MENSES. 

Where active inflammation ensues, a full cathartic of 
Podophyllin and Cream of Tartar should be given in the 
commencement, followed by cold packs to the bowels, and 
full doses of Muriated Tinct. of Iron and Quinine. If 
convulsions are connected with the inflammation, Gelse- 
min, Lobelin, and Belladonna, should be used in sufficient 
quantities until that symptom is relieved. During the 
inflammatory stage, the patient must be kept quiet, but 
in the congestive form of the disease, moderate exercise 
should be taken. 



CESSATION OF THE MENSES. 

At the period of life when the menses should cease, the 
discharge usually becomes irregular; sometimes being 
obstructed for two or three months or more. Among 
the symptoms of this period, are nausea and vomiting, 
swelling of the abdomen, tenderness of the breasts, &c. 
These symptoms are frequently mistaken for pregnancy ; 
connected with the above, there are frequently uterine 
pains, with dragging sensation in the back and loins ; at 
times there is fever, accompanied by violent headache, a 
fall, strong pulse, a loaded tongue, and symptoms of indi- 
gestion. The nervous system generally sympathizes with 
the other affections, causing nervous headache, neuralgic 
pains; periodic diarrhoea, and costiveness. These symp- 
toms may all be mitigated by a sudden return of the 
menses, which may last much longer than is natural, and 
also be more profuse ; upon their cessation they may 
again return in an aggravated form. 

This period in female life is truly designated the critical 
period ; and, although this is necessarily the case, owing 
to the important physiological changes which occur at this 
time, yet it is frequently made much more so, from the 
abuse of quack medicines. 



CESSATION OF THE MENSES, 261 



TREATMENT. 

When the symptoms are slight, but little more will be 
necessary than to regulate the bowels and diet, bathe the 
surface, and occasionally to wear a pack on the lower 
portion of the bowels, wet with equal parts of water and 
whiskey ; but, where the symptoms are severe, in addition 
to this, a purgative of anti-bilious physic should be taken 
and afterward the following compound : 

R Aletrin gr. xxx. 

Cypriped.in gr. xx. 

Pterin gr. xxx. 

Carbonate of Iron. gr. xxx. 

White Sugar , giij. 

Mix, and add to one pint of Port-wine. Dose, .one table- 
spoonful three times a day. Also, 

U Irisin.... gr. xxx. 

Hyoscianrin. gr. v. 

Podophyllin gr. ij. 

Extract of Dandelion sufficient to make thirty pills. Let 
one be taken night and morning. 

If neuralgic pains should occur, 

U Belladonna gr. j. 

Quinine gr. xv. 

"White Sugar gr. xx. 

Mix, triturate, divide into eight powders, and take one 
three times a day. Constitutional symptoms of every va- 
riety manifesting themselves during the period, should be 
met with such remedies as are indicated. 



262 DISEASES OF THE OVARIES. 



DISEASES OF THE OTAEIES. 

The ovaries are subject to a number of diseases, as 
dropsy, sarcoma, hypertrophy, atrophy, &c. Among the 
most common is dropsy ; hence, I shall confine this article 
mostly to that disease. 

SYMPTOMS. 

A slight fugitive pain will be felt in the region of the 
ovaries. The ovary will be found to be larger on one 
side than on the other. This tumor, which is but very 
small at first, gradually increases in size, until it finally 
presses upon the uterus and vagina, causing uterine and 
vaginal irritation, difficult micturition, and prolapsus ani. 
On examination, the tumor may be felt between the vagina 
and rectum. This is particularly the case before it becomes 
very much enlarged. Sometimes this tumor ascends into 
the cavity of the abdomen, and presents very much the 
appearance of the gravid uterus. The tumor may gradually 
increase until it becomes of an enormous size. 

A specimen is now in the museum of the Eclectic Col- 
lege of Pennsylvania, of a tumor which grew to such an 
enormous size as to contain over three gallons of fluid. 
In some instances, the fluid becomes spontaneously ab- 
sorbed. This occurred in a case which came under my 
observation, where the ovarian cyst was of a size sufficient 
to hold a gallon. 

In other cases, inflammation occurs in the cyst, which 
may produce death. Sometimes the cyst adheres to the 
parietes of the abdomen, to the bowels, or vagina ; in this 
event, occasionally, a fistulous opening occurs, and the 
fluid makes its escape ; but as the internal membrane of 
the cyst is so organized as to constantly secrete this gela- 
tinous fluid, a discharge will be maintained until death 
ensues from exhaustion. 



DISEASES OF THE OVARIES. 263 



TREAT 31 ENT. 

I do not propose to speak of the surgical treatment of 
this disease, but to confine my remarks entirely to that 
form of medical treatment which has proved successful in 
my hands in removing the disease in its early stage. 

In the commencement, a pad should be placed over the 
tumor, kept in its place and caused to make gentle pres- 
sure upon it, by a bandage passing around the body. The 
pad should be vet with the Tinct. of Iodine before ap- 
plying it, and afterwards once or twice a day throughout 
the entire treatment. The bandage should be so adjusted 
as to maintain a constant pressure. The patient may also 
take the following syrup : 

U Syrup of Iodide of Iron..... Oss. 

Syrup of Stillingia Oss. 

Dose, one teaspoonful four or five times a day. The 
bowels should be evacuated once or twice a week with 
Cream of Tartar and Podophyllin. When this course 
has been pursued for four or five weeks, substitute the 
folio whig : 

R Syrup of 3Iarshraallow Oj. 

Iodide of Potassium gij. 

Mix, and give one teaspoonful four times a clay, occasionally 
using the purgative as before. 

This treatment persisted in, has in my hands proved 
successful in several cases of ovarian dropsy, and in some 
where it was considerably advanced. The pressure, in 
connection with the Iodine, acts as a constant stimulant 
to the absorbents, and by the alterative effect of the medi- 
cine, the cyst ceases to secrete the gelatinous fluid. 



264 SCROFULA. 

SCROFULA. 

Scrofula, says*Erieksen, is a peculiar constitutional con- 
dition, either hereditary or acquired, that leads to the 
formation of, and in its full development is characterized 
by the presence of tubercle. It is, however, only when 
fully developed that scrofula gives rise to the local deposit 
of tuberculous matter. The constitutional condition that 
tends to this is sufficiently characteristic ; but although we 
may recognize its existence, and speak of the individual 
possessing such a constitution, as having a scrofulous 
tendency or diathesis, he can scarcely be considered to 
labor under the fully formed disease, unless tubercle be 
deposited in some of the tissues or organs. The scrofu- 
lous diathesis is a peculiar constitutional state that is 
often erroneously confounded with general debility. It 
may and often does co-exist with this, but is by no means 
synonymous with weakness of constitution. Debility often 
exists without any scrofulous tendency or taint, more par- 
ticularly in individuals of the nervous temperament; many 
delicate people, though weak, being perfectly healthy, and 
showing no disposition to this peculiar affection ; on the 
contrary, the scrofulous tendency is often conjoined with 
much muscular power and mental activity, no weakness 
being manifested in either of these respects. Scrofula is 
invariably conjoined with debility and a perversion of the 
nutritive functions of the organism. This is especially mani- 
fested in certain tissues, such as the mucous and cutaneous, 
and in those organs the vitality of which is low, as the 
lymphatic glands, the bones and joints. In these, scrofula 
is especially apt to influence the products of nutrition and 
of inflammation, more particularly during the earlier 
periods of life, when these actions are most energetic, in 
such a way as to render its existence evident to the sur- 
geon. It is this tendency to the occurrence of particular 



SCROFULA. 265 

diseases, and to the engrafting of special characters on 
affections of certain tissues, that may be considered as 
specially indicative of the scrofulous diathesis, of that 
condition which, in its fulness of development, gives rise 
to deposits of tubercle in the organs and tissues. 

The existence of this diathesis is marked by the presence 
of a peculiar temperament, — by special modifications 
of the seat, form, and products of inflammation, and, lastly, 
by the development of tubercle. 

The scrofulous temperament assumes two distinct forms, 
and each of these presents two varieties. The most com- 
mon, is that which occurs in persons with fair, soft, and 
transparent skin, having clear blue eyes, with large pupils, 
light hair, tapering fingers, and clear white teeth ; indeed, 
whose beauty is often striking, especially in early life, being 
dependent rather on roundness of outline, then grace of 
form ; and whose growth is rapid and precocious. In 
these individuals the affections are strong, and the pro- 
creative powers considerable; the mental activity is great, 
and is usually characterized by much delicacy and softness 
of feeling, and vivacity of intellect. Indeed, it would ap- 
pear that the nutritive, procreative, and mental powers 
are rapidly and energetically developed in early life, but 
become proportionably and prematurely exhausted. In 
another variety of the fair scrofulous temperament, we find 
a coarse skin, short and rounded features, light grey eyes, 
crisp and curling sandy hair, a short and somewhat ungainly 
stature, and clubbed fingers ; but not uncommonly, as in 
the former variety, great and early mental activity, and 
occasionally much muscular strength. 

In the dark form of the scrofulous temperament, we 
usually find a somewhat heavy, sullen, and forbidding 
appearance ; a dark, coarse, sallow, greasy-looking skin ; 
short, thick, and harsh curly hair ; a small stature, but 
often a degree of torpor or languor of the mental faculties, 
23 



266 SCROFULA. 

though the powers of intellect are sometimes remarkably 
developed. The other dark strumous temperament is 
characterized by clear, dark eyes, fine hair, a sallow skin, 
and by mental and physical organization that pretty closely 
resembles the first-described variety of the fair strumous 
diathesis. 

In all these varieties of temperament, the digestive 
organs will be found to be weak and irritable. This con- 
dition, which I believe is invariably associated with struma, 
and the importance of which* has been pointed out by Sir 
James Clark, must be regarded as one of the most essential 
conditions connected with scrofula, and as tending greatly 
to that impairment of nutrition which is so frequent in 
this state. This gastric irritability is especially charac- 
terized by the tongue, even in young children, being 
habitually coated towards the root with a thick white fur, 
through which elongated papillae project, constituting the 
pipped or strawberry tongue ; the edges and tip, as well 
as the lips, being of a bright-red color. This state of the 
tongue is aggravated by stimulants, high living, and the 
habitual use of purgatives. In the fair varieties, the 
bowels are usually somewhat loose ; but in the dark forms 
of struma, there is a torpid condition of the intestinal 
canal. In all cases the action of the heart is feeble, the 
blood is thin and watery, and there is a tendency to cold- 
ness and often to clamminess of the extremities. 

One of the most marked characteristics of struma, is 
certainly the peculiar modification that inflammation 
undergoes, whether we regard the course that it takes, the 
form that it assumes, its products, or its seat. The course 
of inflammation in strumous subjects is always slow, 
feeble, and ill-developed, the more active and sthenic con- 
ditions being rarely met with. In its form, it is either 
ulcerative, congestive, or suppurative, and in its products 
it is characterized by little tendency to adhesion, by the 



SCROFULA. 267 

production of thin, weak, blue, and ill-developed cica- 
trices, and by the formation of thin, curdy pus, with much ■ 
shreddy corpuscular lymph. 

The seat of strumous inflammation varies greatly ; the 
peculiar modifications of its course, form, and products, are 
assumed, according to the part that it affects. The tissues 
implicated by it, are chiefly the skin and mucous mem- 
branes, the joints, and the bones ; occasioning a great 
variety of special diseases, according as one or another of 
these structures is affected. It is as the result of, or in 
connection with, these local affections, that the general 
symptoms of struma become most marked. Whatever the 
temperament may be, the individual becomes emaciated, 
sallow, cachectic, and debilitated, and at length falls into 
a state of hectic or marasmus. . 

When affecting the skin, scrofula declares itself under a 
variety of cutaneous eruptions, especially the different 
forms of eczema of the scalp, and various ulcers on the 
surface, usually weak and largely granulating, with con- 
siderable swelling of surrounding parts, and a tendency to 
the formation of thin, blue, and glazed cicatrices. 

The mucous membranes are commonly extensively 
affected, and often present the earlier forms of scrofulous 
disease in childhood ; this is more especially the case with 
those of the eyelids and nose. The conjunctiva becomes 
chronically inflamed, with# perhaps ulceration of the 
cornea ; the mucous membrane of the eyelids may be 
permanently congested and irritated, with loss of eyelashes, 
constituting the different forms of psorophthalmia. The 
mucous membrane lining the nostrils becomes chronically 
congested, red, and swollen, giving rise to habitual sniff- 
ling of the nose, and to a sensation as of a constant cold. 
Occasionally the lining of the antrum becomes irritated, 
and may then occasion an enlargement of this cavity, or 
the discharge of unhealthy pus into the nostrils. The 



268 SCROFULA. 

tonsils are often found chronically enlarged and indurated, 
with occasional tendency to fresh inflammation ; and the 
larynx may become the seat of various forms of aphonia, 
dependent on congestion of its lining membrane. The 
state of the gastro-intestinal mucous membrane, has al- 
ready been described when speaking of the state of the 
tongue ; and that of the genito-urinary organs is also 
marked by a tendency to. debility and irritation, indicated 
by the occurrence of discharges from the urethra, under 
the influence of very slight exciting causes, and that are 
often very permanent in their character. The occurrence 
of calculus in the bladder, especially in children, may 
also occasionally be attributed to the scrofulous diathesis. 

Perhaps the most important local diseases arising under 
the influence of this agency, are those of the bones and 
joints. The bones are liable to the occurrence of various 
forms of caries and necrosis ; more especially those that 
are spongy in their texture, as the short bones of the foot, 
and the articular ends of the long bones. The joints are 
liable to that large class of affections that are commonly 
known as ivhite swellings, and which consist of thicken- 
ing, disorganization, ulceration, and suppuration of the 
synovial membranes and cartilages. 

Lastly, some of the glandular organs are peculiarly 
prone to scrofulous disease. Enlargement of the lym- 
phatic glands, more particularly those at the side of the 
neck, and the glands of the jaw, is of such frequent oc- 
currence, and is usually so early a sign, that the surgeon, 
in determining whether an individual is scrofulous or not, 
commonly passes his hand over the glands in these situations, 
in order to ascertain their condition and size ; these glan- 
dular enlargements are especially apt to run into un- 
healthy and chronic suppuration. The testes and the 
mammae are occasionally affected; and other glandular 



SCROFULA. 269 

structures, though sometimes implicated, are by no means 
so commonly found diseased, as those just mentioned. 

The occurrence oitvhercle must be looked upon as the dis- 
tinctive characteristic of scrofula, and when it occurs it may 
be considered a sure sign of this affection, which has then 
reached its ultimate development. In those cases in which 
the scrofulous diathesis exists without having given rise to 
this product, it must be considered as not having been 
called into full and active operation, having merely mani- 
fested itself in the minor forms of the disease, such as 
ulceration of the skin and mucous surfaces. 

Tubercle, though sufficiently well marked by its appear- 
ances and progress, cannot be looked upon as a specific 
affection, but must be considered to be a perverted or un- 
healthy development of the nutritive materials, destined 
for the repair of the body and the restoration of the blood. 
According to Mr. Simon, it consists of the lymph or nas- 
cent blood. It is a "dead concretion," a " fibriniform 
product, insusceptible of development. '_? " The scrofulous 
diathesis," says Mr. Simon, "consists in a peculiarity of 
blood development, under which the nascent blood tends 
to molecular death by superoxydation." According to 
Dr. Williams, tubercle is a degraded condition of the 
nutritive material from which the old textures are renewed, 
and the new ones formed, and it differs from fibrin e or 
coagulable lymph, not in kind, but in degree of vitality 
and capacity of organization. " 

" Tubercle essentially occurs in two forms, as semi-trans- 
parent grey granulations, smooth and cartilaginous in 
look, somewhat hard, closely adherent, and accumulated 
in groups, often with a good deal of inflammatory action 
in the surrounding tissues. These grey granulations, 
usually about the size of a small pin's head, appear to con- 
sist of a modified exudation of matter. They have a tendency 
to run into masses, and to form the true yellow tubercle, 
23* 



270 SCROFULA. 

which is met with in opaque, firm, but friable concretions, 
of a dull whitish or yellowish color, homogeneous in struc- 
ture, and without any appearance of vascularity. 

The microscopic characters of tubercle present no very 
specific appearances. We find that this product presents 
under the lens, a homogeneous struma, w T hich chiefly occurs 
in the grey granulations, a granular matter which is prin- 
cipally met with in yellow tubercles, drops of molecular 
oil, and, lastly, considerable quantities of imperfectly de- 
developed exudation cells, more or less disintegrated, 
stationary or degraded. 

The progress of tubercle is most commonly to disinte- 
gration and liquefaction, at the same time that it gives 
rise, by its irritation, to inflammation and suppuration in 
the surrounding tissues ; hence it commonly leads to ab- 
scesses, the pus of which is always curdy and shreddy. In 
some cases tubercle may become indurated, and undergo a 
species of calcification. The causes of scrofula, unless this 
be of an hereditary character, though very various in their 
nature, are usually such conditions as influence injuriously 
the nutrition of the body. The hereditary nature of 
scrofula is well known, both to the public and to the pro- 
fession, for although the disease is not commonly connate, 
yet the tendency to it is, and the characteristic nature of 
the affection often manifests itself at an early period, not- 
withstanding every effort to prevent its development. That 
a parent may develop a tendency to malnutrition, to mis- 
development of the blood, just as he may a peculiar feature 
or mental condition, is undoubted. It is by the hereditary 
transmission of peculiar combinations and modifications 
of action in the organization, that hereditary diseases 
develop themselves at certain periods in the life of the 
offspring, when the injurious results of the morbid actions 
that have been transmitted, have had time to be produced. 
There are certain conditions which, though not scrofulous, 



SCROFULA. 2"1 

are supposed to have a tendency to develop this disease in 
the offspring to which they are transmitted ; thus dyspeptic 
parents are said, and I believe with reason, to have stru- 
mous children; so, also, the offspring of very old or very 
young people, often exhibit a proneness to scrofulous 
affections. The influence of intermarriage is still a matter 
of doubt, though I believe it exerts but little influence in 
this respect, and it is commonly stated that the inhabitants 
of little communities, who intermarry closely, such as those 
in the isles of Portland and Man, are not more liable to 
scrofula than other individuals. The most potent cause 
of scrofula, and that which in civilized countries is like- 
wise most frequent, is mal-nutrition, arising either from 
want of food, or the use of inferior food by the poorer 
classes, or from over-feeding, .and over-stimulation of 
the digestive organs in the children of the wealthier 
orders of society, thus inducing chronic irritation of 
the mucous membrane of the stomach, interference with 
the digestive powers, and consequently with nutrition. 
The influence of food that is insufficient in quantity, or 
innutritious in quality, has been shown by Mr. Phillips, in 
his excellent treatise on scrofula, to be the more immediate 
cause of this disease ; and when conjoined with the injuri- 
ous atmosphere of large towns, of close and over-crowded 
rooms, and want of light and exercise, may be considered 
as sufficient to occasion the disease in those cases in which 
no predisposition to it exists, and greatly to develop any 
tendency to it in the system. It is to the conjoined influ- 
ence of agencies such as these, that we -must attribute the 
prevalence of scrofula amongst the lower orders of town 
and rural populations. 

Scrofula is often called into immediate action by the 
debility induced by previous diseases, such as measles, 
scarlatina, hooping cough, &c. It usually develops itself 
at an early age, though seldom before the child has reached 



272 SCROFULA. 

its second year. It is most commonly about the period 
of the second dentition that the disease declares itself, 
and it is rare to meet with it, for the first time, after the 
ages of twenty-five or thirty-five. 

According to Phillips, when it is fatal it generally 
proves so before the fifteenth year; 60 to 70 per cent, of 
the deaths occurring before this age. Sex does not ap- 
pear materially to influence this disease, though according 
to the same authority, the deaths of males from scrofula, 
exceed those of females in this country by 20 per cent. If, 
however, we are to regard phthisis as an allied affection, 
people who are scrofulous in early life, often having 
phthisis developed at a later period, these numbers may 
require correction. 

TREATMENT. 

The treatment of Scrofula may be divided into preven- 
tive and curative. The preventive treatment consists in 
so regulating the diet, as to supply all deficiencies in the 
histogenic material of the different tissues. The digestive 
and assimilating organs should receive special attention, 
every possible effort being made to increase their tone. 
The surface should be bathed three or four times a week 
in warm or cold water, as best agrees with the constitu- 
tion. A liberal amount of exercise in the open air should • 
be taken, and the patient should avoid all excesses, both 
physically and mentally. When these means fail to arrest 
the tendency to scrofula, a moderate amount of stimulants, 
in combination with small quantities of Iron, may be 
taken before each meal. When the disease has become 
fully developed, whether in the skin, lungs, bones, liver, 
stomach, uterus, kidneys, or any other part of the system, 
the constitutional treatment should consist in a thorough 
tonic and alterative course. In case the disease appears 
in the form of herpes or pustules, the treatment has been 
fully described under that 'head. Or, if in the form of 



SCROFULA, 213 

phthisis, the treatment has already been given. "When 
scrofula manifests itself in the form of ulcers, of an indo- 
lent or irritable character, the constitutional treatment 
should consist of the following remedies : 

B Scrophularin gr. xx. 

Bitartrate of Iron gij. 

Chloride of Sodium srj. 

White Sugar giij. 

Mix, triturate, and take one teaspoonful three times a day. 
The diet should consist of rich animal broths, ripe fruit, 
&c. ; and a wine-glass full of malt liquor should be drunk 
with each meal. The ulcer should be stimulated by the 
occasional application of a mild solution of sulphate of 
zinc, or vegetable caustic. The limb should be bandaged 
with moderate tightness, and the ulcer covered with a soft 
slippery elm poultice. After the above treatment has 
been pursued for about two weeks, it should be changed 
to the following : 

R Compound Syrup of Stillingia Oss. 

Syrup of Apocynum Oss. 

Syrup of Iodide of Potassium gij. 

Mix; dose, from one teaspoonful to one tablespoonful 
three times a day. This treatment should be pursued for 
two or three weeks, when it should be omitted, and the 
following substituted : 

R Phosphate of Lime gss. 

Carbonate of Iron giij. 

Phytolacein , gr. xv. 

White Sugar ibj. 

Mix, triturate and add to one pint of water, and one pint 
of best gin. Dose, one tablespoonful three times a clay. If 
the ulcer should still prove indolent, it may be touched 
with caustic of potassa, followed by a poultice of slippery 
elm, wet with Tinct. of Arnica. Where the disease appears 
in the form of caries or necrosis of the bone, the dead por- 



274 piles. 

tion should be destroyed by the sulphate of zinc or 
caustic potassa. The sore should be stimulated as in ulcer 
of the soft parts, until it becomes healthy. After which, 
collodion or a mild ointment may be applied, until union 
takes place. In no case, however, in disease of the bones, 
should the ulcer be allowed to heal until the necrosed por- 
tion of bone has been entirely exfoliated, and the ulcer 
healthy in every respect. 

Where scrofula attacks the glands of the axilla, groin, 
or breast, causing enlargement and irritability of these 
parts, absorption should be promoted, if practicable, by the 
use of Iodine ointment and moderate pressure ; if this fails, 
suppuration may be induced by the application of a poul- 
tice of equal parts of gum -myrrh, capsicum and slippery 
elm. In such cases, Phytolaccin, Iodide of Potassium, 
Apocynin, in connection with the compound alterative 
syrup, are the remedies to be used. In the treatment of 
this disease, the surface should be frequently bathed, the 
diet should be nutritious, and consist of both vegetable and 
animal food. The sleeping apartments should be freely 
ventilated, and the habits of exercise well regulated. 



PILES, OR HEMORRHOIDS. 

A varicose condition of the hemorrhoidal veins, allowed 
to exist for a considerable length of time, causes a disease 
of its coats, and a consequent infiltration into the adjacent 
cellular tissue. 

The blind piles are essentially the same, only occurring 
higher up in the rectum. 

SYMPTOMS. 

A greater or less number of dark purple or pulsating or 
erectile tumors around the margin of the anus, or within 



piles. 275 

the anus. They mostly cause much pain, and in some 
cases the oedema of the parts is so great that defecation 
is almost impossible. In other cases there are constitu- 
tional symptoms, as fever, headache, loss of appetite, 
debility, &c. Where the patient is of a scrofulous dia- 
thesis, piles may terminate in fistula in ano. 

CAUSES. 

The causes of hemorrhoids are congestion of the liver, 
costiveness, ascaricles, pregnancy, and all affections which 
tend to produce inflammation of the parts. 

TREATMEXT. 

R Sulphur gr. xxx. 

Cream of Tartar ; gij. 

Cane Molasses Oj. 

" Best Gin Oj. 

Mix ; dose, from one teaspoonful to one tablespoonful three 
times a day. Shake the mixture well before taking. As 
an external application, an ointment may be used com- 
posed of the following ingredients : 

R Tannin gj. 

Fresh Lard gj. 

Sulphate of Zinc... gr. vj. 

Mix, form an ointment, and apply after each movement 
of the bowels. Where the hemorrhoids are confined to the 
upper portion of the rectum, and are accompanied with 
hemorrhage, from five to ten drops of the oil of Erigeron 
should be taken three or four times a day. If the first 
mixture should not be sufficient to maintain a soluble con- 
dition of the bowels, from one eighth to one fourth of a 
grain of Podophyllin should be taken every night on going 
to bed. When the piles first make their appearance, they 
can generally be removed by returning the pile tumor, and 



2t6 FISTULA IN ANO. 

afterwards rubbing gently with the finger which has been 
anointed with simple cerate, until the congested veins 
become emptied, and the tumor disappears. 



FISTULA IN ANO. 

This is an indolent ulcer, situated in the lax cellular 
tissue, adjacent to the rectum. This ulcer or sinus usually 
communicates externally with the sphincter muscle, by 
means of a small pipe, in which case it is called an open 
fistula. Occasionally it communicates with the intestine, 
without any external opening, in which case it is called a 
blind fistula. 

CAUSES. 

Fistula in Ano may be caused by piles, injuries of the 
part, or anything which will cause cellular inflammation 
in these parts. 

SYMPTOMS. 

These are often quite obscure, at other times a heavy dull 
pain will be felt in the region of the anus, extending at 
times to the back, accompanied by febrile reaction, scanty 
urine and accelerated pulse. Sooner or later a small 
tumor will make its appearance, and is usually mistaken 
for piles ; but on opening, a small quantity of sanious mat- 
ter will be discharged, which will continue until the disease 
is removed. Or if blind fistula, the pain and constitutional 
symptoms may be followed by a discharge from the bowels, 
through the communication between the intestine and the 
sinus, by the completion of the fistulous tube, 

TREATMENT. 

As this disease is usually connected with a scrofulous or 
tuberculous habit, a constitutional and local treatment 



MERCURIAL DISEASE. 277 

should be commenced at the same time. The patient 
should take Alterative Syrup, Iron, Quinine, and Iodide 
of Potassium, with such other remedies as the state 
of the disease may indicate. At the same time, the 
fistula should be injected with a strong solution of sul- 
phate of zinc. The injection should be of sufficient 
strength to disorganize the walls of the sinus, and the 
fistulous tube. After the fistula has been injected, the 
parts should be brought as closely in contact as possible, 
by means of adhesive straps. The injection should be 
repeated from time to time, until the fistula is entirely 
cured. Or if, after disorganizing the tube with the zinc, 
the ulcer still proves obstinate, a strong solution of bay- 
berry and golden seal will generally effect a cure. 

If it is a blind fistula, an external opening should be 
made by means of the caustic potassa, and followed by 
an injection as before. Previous to injection of the zinc, 
where the opening communicates with the intestine, the 
rectum should be injected with slippery elm, to prevent the 
caustic from comins: in contact with the bowels. 



MERCURIAL DISEASE. 

There is no disease more formidable in its attack upon 
the organic tissues than this ; not only in its tendency to 
develop a great variety of pathological conditions, but in 
the peculiar obstinacy with which it resists the efforts of 
the physician to arrest its progress. I\Iercurial diseases 
manifest themselves in periodic rheumatic affections of 
the joints, in enlarged and indurated condition of the 
various glands of the body, in the form of dropsies, 
anaemia, phthisis, palpitation of the heart, dyspepsia, blind- 
ness, deafness, loss of teeth, convulsions ; in fact, there is 
no form of disease that is not occasionally represented by 
24 



2T8 MERCURIAL DISEASE. 

the disastrous influence of mercury. When once intro- 
duced into the system, the manner in which mercurial pre- 
parations affect the different tissues, is as yet a matter of 
some dispute. Although it is claimed by those who still 
persist in its use, that it possesses the power to change the 
morbid condition of the part affected into another morbid 
state, which is far less dangerous to the life of the patient 
than the primary affection ; that it acts as a stimulant to 
the liver, and a. purgative to the bowels; in short, it is 
claimed by those who still adhere to the dogmatism of 
allopathy, that it is essential to the successful treatment of 
nearly all inflammatory, as well as chronic diseases. But 
in what way it stimulates the liver, or how it arrests fever, 
or subdues inflammation, they are unable to tell us beyo.nd 
mere conjecture. 

It certainly cannot be owing to its power to increase 
the histogenetic material for the reparation of injured 
organs, nor to its tendency to reorganize the blood, or 
other fluids, as the most minute chemical analysis has 
failed to detect the least trace of mercury in the organic 
tissue, unless it had been first introduced into the stomach, 
and then always acting as a foreign agent, and in no way 
identified as an element of the human organism. The 
only way by which the modus operandi of mercurials upon 
the organic tissues can be explained, is that by which we 
explain the inability of all foreign agents to produce 
disorganization, unless the quantity be sufficient to over- 
power the vis-vitas of the part with which it comes in 
contact. When a foreign body is introduced into the ex- 
ternal soft tissue, the vitality of the part is at once sum- 
moned to remove the intruder, consequently a deposition 
of lymph occurs around the foreign body, which soon be- 
comes organized in such a way as to cut off all communi- 
cation between the foreign body and the adjacent tissues. 
Inflammation and suppuration are the agents used to 



MERCURIAL DISEASE. 279 

expel the body, so when mercury is introduced into the 
system, it acts as a foreign body to every tissue with which 
it comes in contact, and an effort is made to expel it. 
When mercury is combined with chlorine, as in calomel, it 
may entirely dissolve the tissues, such as the mucous mem- 
brane of the stomach, bowels, lungs, &c. But whether 
we are able or not to account for all the morbid conditions 
produced by this agent, we have the most positive assu- 
rance,- that in the whole catalogue of predisposing causes 
to disease, there is none more prolific than this. Allo- 
pathists themselves are beginning to observe this fact, in 
confirmation of which, I will introduce the remarks of 
W. Porter, M. D., F. R. C. S. I., &c, as published in the 
Dublin Medical Press of Feb. 10, 1847. 

Dr. Porter observes : "I think that mercurial diseases, 
properly so called, that is, such, as arise from mercury 
alone, admit of subdivision into two classes, according as 
they seem to be products of a small or a large close of the 
poison ; when taken in small quantities, it appears to be 
determined to the tegumentary structure of the skin, the 
mucous membranes and analagous tissues, such as the con- 
junctiva of the eye, and therefore bowel complaints, 
cutaneous eruptions, and superficial inflammations are 
generally met with, at an early period, and before the 
specific effects of the medicine ought to be expected to 
appear ; when taken in large quantities, the nervous system 
is most likely to suffer, and that too where the specific 
effects have not been developed at all, which is the case 
most pregnant with danger, or that being present and in 
fall operation, .they have been suddenly checked, or other- 
wise interfered with, by improper or incautious exposure. 
Some few cases occur whilst patients are under complete 
salivation ; but it is so difficult to say that such may not 
have been guilty of some irregularity, that they may be 
placed within the latter category, and at all events they 



280 MERCURIAL DISEASE. 

are of rare occurrence. Such is the arrangement I propose 
to follow in considering these affections ; not, however, 
without being conscious of its imperfections, and that 
numerous diseases arise, or seem to arise, from the irrita- 
tion of mercury, that run a wild and unbridled course, 
w r hich it would be impossible in the present state of our 
knowledge to subject to this or almost any other classifica- 
tion. Persons, for instance, whilst taking mercury, be- 
come deranged : the examples of this which I have seen 
were all maniacal, and the symptoms such as might be 
expected from inflammation of the brain and its mem- 
branes ; these patients all died. Whether such an event 
w r as the effect of too sudden exposure to wet or cold — 
whether it could be regarded as a kind of metastatic trans- 
fer of the mercurial irritation to the brain, or whether it 
had any direct connection with the mercury at all, I am 
unable to prove, but certainly at the time when each 
occurred, I could not help placing the mercury and the 
madness in the relation of cause and effect. Again, per- 
sons whilst taking mercury have become paralytic. When 
I was in college, a young friend of mine, slightly under 
the influence of the medicine, was exposed to an incessant 
shower of rain for nearly two hours ; he went to bed, where 
he had a rigor, but fell asleep, and awoke perfectly para- 
lytic on one side ; he lived many years afterwards, but 
never recovered the use of his limbs. A young clergyman 
who had taken mercury for a liver complaint, and had 
apparently nearly recovered from its effects, incautiously 
fell asleep on the grass ; he awoke paralytic, and nevei 
recovered, although he lived to more than middle age. 
Perhaps it may be said that these are not fair specimens 
of the morbid influence of mercury upon the nervous 
system ; perhaps it may be doubted whether mercury had 
any relation to such cases at all, inasmuch as persons have 
become paralytic from exposure, who have never taken a 



MERCURIAL DISEASE. 281 

grain of the medicine. I know not how this may be. My 
opportunities of investigation have been too limited to 
enable me to speak with confidence on a matter of so mnch 
obscurity ; but my experience in many instances has led me 
to believe that mercury may prove eminently mischievous in 
this particular manner. But suppose we acknowledge that 
mercury may and does act injuriously on the nervous system 
in all its parts and in its various ways, how are we to account 
for its prejudicial influence on other systems and structures, 
particularly as to its production of an hemorrhagic ten- 
dency ? Several years ago, when investigating the patho- 
logy of aneurism, I remarked the frequency of that disease 
in persons who had been subjected to protracted courses 
of mercury, and I then hazarded an opinion that this 
fearful and dangerous affection might be occasionally thus 
induced ; since then, I have paid great attention to the 
subject, and have observed different kinds of hemorrhage 
so frequently ensue after mercury had been extensively 
used, that I feel convinced of its injurious influence in this 
respect. Almost all the aged people treated with mer- 
cury for syphilis, have, according to my observation, died 
shortly afterwards of haemoptysis, or else of apoplexv ; 
nor are such casualties confined to the aged, for I have 
seen several instances of young persons under similar cir- 
cumstances, being seized with spitting of blood, and dying 
rapidly of consumption. It may be imagined that I am 
presenting the possible injurious effects of mercury in too 
strong colors, and that my apprehensions on this subject, 
as being derived from the experience of a few cases, are 
little more than visionary ; be it so ; but having remarked 
the fact, I think it my duty to state it, and leave it to be 
established or contradicted by future experience. 

" The tendency of mercury to produce a hemorrhagic 
condition, is readily explicable by the effects of the mineral 
upon the fibrin of the blood. " AY. H. Ranking, M. D. 
24 * 



282 MERCURIAL DISEASE. 

Mercurial erythema is sometimes preceded by symptoms 
resembling those which usher in erysipelas, shivering, 
nausea, foul tongue, thirst, headache, cough, and pains 
about the praacordia, and these febrile symptoms, not only 
continue throughout, but in severe cases become daily ag- 
gravated ; sometimes it occurs without any premonitory 
notice, except 'a harsh dryness of the skin ; and I have 
known it to appear suddenly the day after the administra- 
tion of three or four grains of calomel as a purge. It may 
be a consequence of administering mercury in any of its 
forms or preparations, but seems more frequently produced 
by its administration internally. I have, however, seen an 
exceedingly well marked case of it from dressing a sore 
with the red precipitate. It appears as a dark red blush 
at some of the folds of the body, the seat of the scrotum, 
the groin, axillae, or anterior parts of the elbow, from 
which it spreads with a greater or less degree of rapidity, 
according to the severity of the case. This is distinguished 
from ordinary erysipelas, by its surface being slightly rough 
to the touch — by its edge not being distinctly defined — by 
its intolerable itching, which is the local inconvenience 
chiefly complained of in the first instance — and by its 
vesicular appearance when viewed through a magnifying 
glass. Whenever the surfaces of the body lie in opposite 
contact, such as in the perineum, the inside of the thighs, 
or between the folds of the nates, these vesicles break 
almost as soon as formed, the parts become abraded, and 
there is a constant oozing of a serous fluid, foul and abomi- 
nably fetid. In modern times, the disease seldom pro- 
gresses beyond this, which is termed the first stage ; but 
suppose it neglected, and the use of mercury still perse- 
vered in, the febrile symptoms become exasperated, the 
eruption spreads, and may so extend as to occupy the 
entire body, and the vesications, or rather vesicles, run 
into each other and break. Where surfaces are opposed, 



MERCURIAL DISEASE. 283 

the discharge increases in quantity, assumes a puriform 
character, and becomes, if possible, still more offensive ; 
when they do not, a branny scurf or scale is formed, which 
falls off, and is renewed so abundantly, that after the night, 
or even after a few hours, a great quantity may be found in 
the patient's bed. In general, this desquamation of the 
skin is attended with febrile symptoms, and the patient 
slowly recovers ; but if otherwise, if the disease has been 
more than usually malignant, or if the medicine has been 
still persevered with, the parts engaged (and these may be 
the entire body) swell, apparently by the formation of 
thicker scabs or crusts, which are deeply cracked or fis- 
sured (not inaptly compared to the scored skin of roasted 
pork), discharging sometimes sanies, sometimes blood, and 
so sore and painful that the patient can scarcely bear to 
turn himself in bed. I am not quite sure that I ever saw 
a fatal case of mercurial erythema. About five years ago 
a poor Scotchman was brought into the hospital covered 
with a scurfy eruption, and in a miserable state of debility, 
who attributed his illness to having taken some medicine, 
which he believed to have been corrosive sublimate, for 
the cure of clap, in despite of the treatment, he died (as 
several thought) of this disease ; but if it was so, there was 
a symptom here present not described hitherto as apper- 
taining to it, namely : a discharge of purulent matter as 
foul and offensive as that from a glanderecl horse, from 
every mucous outlet of his body, mouth, nostrils, eyes, ears, 
anus and urethra. I know not, I say, whether this was a 
specimen of the disease or not; but without passing to 
such extremity, the description given by those who had 
witnessed the latter stages of the malignant erythema, is 
sufficiently appalling. The cough becomes very severe, 
and is accompanied by great soreness of the chest ; the 
matter expectorated is sometimes highly tinged with blood, 
which is so coagulated as to threaten suffocation. The 



284 MERCURIAL DISEASE. 

pulse is frequent and irregular, the surface of the body is 
intensely hot and sore, the thirst becomes unquenchable, 
the tongue becomes parched and black in the centre, and 
the urine is high-colored, small in quantity, and without 
sediment, "Wretched, indeed, is the situation of the 
patient in this stage of the disease ; without the enjoy- 
ment of one moment's repose, afflicted in body with the 
most excruciating anguish, and depressed in mind to the 
lowest state of despair, he soon falls beneath these com- 
plications of wretchedness. Diarrhaea and low delirium 
speedily supervene, the pulse sinks, the body mortifies, 
and a state of insensibility at length announces the termi- 
nation of a complaint that at once exhibits a distressing 
proof of the inefficiency of medicine, and the insufficiency 
of human skill." 

Before I speak of the treatment, allow me to revert for 
a moment to the history of this disease. Alley states, 
"that before the nature of this disease was known, it was 
considered as a more virulent form of Syphilis. In 
proportion, therefore, as the disorder advanced, mercury 
in some form or other was exhibited in greater quantity ; 
the fever, consequently, was soon found to be increased to 
an alarming degree, by the action of the mercury thus 
heaped upon an already overloaded system ; and lest the 
patient should sink too rapidly under the oppression of 
this fever, recourse was had to tonics and stimulants. 
Among these the bark and wine were resorted to, without 
any regard to symptoms and appearances. It is almost 
unnecessary to add, that the disease was in almost every 
instance dreadfully aggravated, and that very few re- 
covered. " Now, recollect that all this happened in a 
Lock Hospital, and at a time when all cases of venereal 
disease were treated with mercury. The patient was sur- 
rounded by, and actually breathing a mercurial atmo- 
sphere, and you can easily understand why medicine and 



MERCURIAL DISEASE. 285 

medical skill were inefficacious and insufficient. It was 
useless to prescribe purgatives, and acids, and antinionials, 
and other cooling medicines, the cause of the fever re- 
maining ever present ; it was in vain to endeavor to 
support the strength by bark, and wine, and opium, while 
the tendency to putrescence was constantly on the increase. 
At present the disease is known to be mercurial. 

Mercurial Erethismus. — Mr. Pearson tells us, that in 
the course of two or three years after his appointment to 
the Lock Hospital, he observed that in almost every year, 
one or two cases of sudden death occurred among the 
patients ; that these could not be traced to any ostensible 
cause, and that the subjects were those who had nearly 
and sometimes entirely completed their mercurial course. 
He consulted Messrs. Bromfield and Williams on the 
subject, and they were unable to give him any information, 
more than that they had carefully examined the bodies of 
many who had thus died unexpectedly, without being able 
to discover any morbid appearances. On watching the 
effects of mercury on the patients, he ascertained that 
these deaths were attributable to the mineral acting as a 
poison on the system, and that its deleterious effects were 
neither in proportion to the inflammation of the mouth, 
nor to the actual quantity of mercury absorbed into the 
body." 

TREATMENT. 

The treatment of mercurial disease is usually less suc- 
cessful than the treatment of most other diseases ; although 
much good may frequently be done by a proper course of 
medication. 

If mercurial disease is manifested in a mild form, the 
patient should be caused to take a gentle purge of Podo- 
phyilin, the surface should be freely bathed in salt water, 
a mild course of tonics should be commenced and pursued, 



286 MERCURIAL DISEASE. 

and a generous diet should be allowed. This course will 
frequently remove the most troublesome symptoms. 

In more severe cases, as much of the mercury should 
be extracted from the system as possible, by recourse to 
the galvanic battery. After which, Compound Syrup of 
Stillingia, in connection with small doses of Sulphur, will 
be required. The surface should bo frequently bathed in 
Saline water, and Iron and Hydrastin given in doses suffi- 
cient to maintain the patient's strength. Where the dis- 
ease appears to confine its poisonous action chiefly to the 
skin, much benefit will frequently be derived from the use 
of an ointment made of equal parts of tar and sulphur. 

IMPORTANCE OF CERTAIN SYMPTOMS IN DIAGNOSIS. 

In order to form a correct opinion of the nature, cha- 
racter, and identity of disease, it is necessary to take a 
general survey of the physical characteristics of the 
patient : as his weight, height, temperament, age, whether 
his constitution is of a strumous or scrofulous diathesis, 
whether of temperate habits, and whether he has been 
subjected to a mercurial course of medication. 

Every possible item of information relative to the dis- 
ease, should be obtained from the patient and nurse, which 
will in the least assist in forming a correct diagnosis of 
the case. If the heart, lungs, liver, or spleen are impli- 
cated, auscultation, percussion, palpation, and mensura- 
tion, should be practised, for the purpose of forming a 
correct opinion of the true nature of the disease. Some 
of the special symptoms which should engross our atten- 
tion, are the appearance of the tongue, the appetite, 
respiration, circulation, sleep, the skin and secretions, and 
state of the intellect. Pain is the result of some impres- 
sion made upon the nerve, and transmitted to the braiu ; 
the pain may be remote from the impression, as in hip 
disease the pain is generally in the knee ; the irritation 



DIAGNOSTIC SIGNS. 287 

causing pain in the head, may be in the stomach ; or pain 
in the shoulder may occur, as the result of congestion of 
the liver. The amount of pain suffered by different indi- 
viduals from the same disease is various, owing to the 
different sensibilities of the persons, and dependent upon the 
temperament. Hence the amount of the pain experienced 
by the patient, is indicative of the amount of the disease, 
ceteris paribus. A dull heavy pain generally indicates 
congestion, effusion, or the pressure of some tu^nor ; fugi- 
tive pain indicates a stretch of some part ; lancinating 
pain is characteristic of cancer, rheumatism, pleuritis, or 
neuralgia ; a heavy, throbbing pain, indicates the collec- 
tion of pus ; itching pain is mostly confined to the skin 
and mucous membrane ; on the skin it is caused by erup- 
tive diseases, and on the mucous surface by ascarides in the 
rectum, &c. When pain suddenly ceases, followed by cold 
clammy sweats, weak pulse, and sunken countenance, an 
attack of the affected part by gangrene is indicated. 

The tongue affords many important indications of dis- 
ease of the digestive organs. When the tongue is thickly 
furred, and of a white or brownish color, it indicates a 
derangement of the mucous membrane of the stomach. 
If, in addition to the above, it should have a red appear- 
ance at the end, it indicates the mucous membrane of the 
stomach to be in a high state of irritation or inflamma- 
tion. A dry red tongue also indicates the same state of 
the stomach. A cracked and swollen tongue, indicates an 
extensive irritation of the nerves of the stomach, and also 
that the brain is involved. When the tongue is tremulous, 
great nervous prostration is indicated. A dry, furred, or 
red and tremulous tongue, is often present in typhoid 
fever. A light, flat tongue, is characteristic of most 
forms of intermittent fever. Much information, relative 
to disease, may be obtained by a thorough knowledge of the 
circulation, as indicated by the pulse. The conditions of 



288 DIAGNOSTIC SIGNS. 

the pulse, indicative of disease, are various. The in- 
creased frequency of the pulse is one of its most common 
varieties, and may exist in a great many pathological 
conditions of the system. The number of beats per 
minute, constituting an increase of pulse, varies much in 
different individuals, and also at different periods of life. 
In infancy, the normal pulse is said to be from 78 to 180 
per minute. Between the age of two and six months, 
from 100 4p 120 per minute. Between the age of two and 
seven years, about 110 per minute. From seven years to 
twenty-five, from 80 to 85. From twenty-five to sixty-five 
years, the average pulse per minute is about 70 to 75. In 
females it will be found to be somewhat faster : the 
number of pulsations per minute is greater during the day 
than night ; and more frequent just after a meal than 
before. From the above statement, it will be perceived 
that a great variety of circumstances must necessarily be 
considered, in order to derive much benefit from this con- 
dition of the circulation in diagnosis. When the pulse is 
slow, or much less than the usual number of beats per 
minute, it frequently indicates disease of the brain ; it is 
also characteristic of other diseases. An intermittent 
pulse indicates either a disease of the brain, or extreme 
exhaustion of nervous energy. A weak and feeble pulse 
indicates anaemia and debility. Hope states, that when 
the pulse is jerking, quick, hard, and strong, and stops 
abruptly, it indicates a deficiency in the semilunar valves 
of the aorta. In inflammation of the peritoneum, the * 
pulse is mostly small and quick, but quick and hard in 
inflammation of the lungs and pleura. When the pulse is 
easily compressed under the finger, it indicates a feeble 
condition of the heart. When the pulse ceases to be felt 
in the extremities, it indicates great danger, unless it is 
merely temporary. The appetite is another symptom of 
much importance to be observed in disease. In most 



DIAGNOSTIC SIGNS. 289 

diseases, the appetite is defective, indicating inability of 
the stomach to digest food, and loss of assimilating power. 
Under these circumstances, food introduced into the stomach, 
acts as a foreign substance, and is the cause of much mis- 
chief. In some diseases the appetite is not defective ; in 
these cases, the powers of the stomach, as well as the 
assimilating functions, remain unimpaired. In some forms 
of phthisis, the rapid exhaustion of the nutritive material 
increases the demand for food beyond its normal amount. 
In chlorosis, the appetite is frequently capricious, craving 
lime, clay, slate, stones, &c. This kind of appetite indi- 
cates a lack *of proper histogenic material, as well as a 
deficiency in the salts of the blood. In children, the 
appetite frequently craves sugar, fats, &c, which indicates 
a deficiency of the combustive material, and a consequent 
loss of temperature. 

There may also exist a variety of morbid appetites, 
such as a craving for stimulating liquors, opium, tobacco, 
ether, &c, all of which indicate a diseased condition of 
the stomach or brain. Respiration should also be care- 
fully noticed in forming a diagnosis of disease. If respira- 
tion is increased in frequency, it denotes obstructed .circu- 
lation through the pulmonary tissue. It may also indi- 
cate irritation of the lungs or bronchial tubes. There are 
a variety of conditions, which may tend to increase the 
functions of respiration. The respiration may be irregular 
and imperfect, as in tuberculous condition of one or both 
lungs, or from a valvular disease of the heart and inflam- 
mation of the pleura. 

The menses are deranged in many diseases. They may 
be scanty or they may be profuse. In some instances they 
are entirely suppressed. They are at times changed in 
quality, and the period of their return may be irregular. 
When the catamenia is scanty, it either indicates a diseased 
condition of the ovaries or deficient nutrition. Suppression 
25 



290 DIAGNOSTIC SIGNS. 

of the menses may indicate a variety of opposite conditions. 
It may depend upon pregnancy, upon nursing, or upon 
age. It may exist in any of these cases without inducing 
disease. The menses may be suppressed by the extreme 
exhausted condition of the system, as in the last stage of 
phthisis, dropsy, &c. Or they may be suppressed by sud- 
den exposure to cold or damp during the catamenial flow. 
The menses may also be vicarious, making their exit from 
the system through the lungs, stomach, bowels, &c. A 
change in the quality of the menses denotes disease of the 
uterus, or ovaries, or a scrofulous diathesis. Excess of the 
menses indicates a chronic inflammation of 'the lympha-tic 
glands of the uterus, spermatorrhea, &c. 

SIGNS FROM THE URINE. 

Healthy urine, when recently voided, has very nearly 
the temperature of the body ; it is of a light yellow color, 
emits a peculiar aromatic odor, has a bitter saline and 
pungent taste, and a slight acid reaction ; its specific 
gravity is about 1.018. From 90 to 93 parts to 100 of 
healthy urine is water, the remainder is made up of uric 
acid, saline and organic matter. 

About 2i oz. of solid nitrogenized and uric matter is 
thrown off from the kidneys every twenty four hours. If 
the urine be acid, it will redden blue litmus paper ; if it be 
alkaline, it will turn red litmus paper blue ; if neutral, it 
will have no effect on the color of either. If the urine 
contains albumen, heat or nitric acid will cause it to co- 
agulate, and give the urine a thick milky appearance. If 
the urine contains blood, heat or nitric acid will cause it 
to lose its transparency. If it contains bile, nitric acid 
will turn it green ; if it contains uric acid, nitric acid will 
cause it to look dark, and precipitate a brownish sediment. 
If it contains sugar, it may be ascertained by evaporating 
a small quantity to the consistency of molasses, which will 



DIAGNOSTIC SIGNS. 291 

have a sweet taste. A milky appearance may be caused 
by mucus, albumen, or ammonia. If it contains ammonia, 
nitric acid will cause a brisk effervescence ; if it contains 
mucus or albumen, nitric acid will cause it to coagulate. 
Dr. Bird states, that if the sediment of morbid urine be 
white, and the urine acid, it consists mostly of urate of 
ammouia ; but if it should disappear by heat, it is phos- 
phate of ammonia. If a deposit be made of any color in- 
clining to dark pink, or reel, it is almost sure to be urate 
of ammonia, unless visibly crystalline, in which case it 
consists of uric acid. When the urine contains albumen, 
it indicates granular degeneration of the kidneys, or Bright's 
disease, unless it is connected with low forms of fevers, or 
in certain forms of heart disease. If the urine contains sugar, 
it indicates mal-assimilation or diabetes mellitus. A gritty 
sediment denotes a tendency to some of the forms of gravel. 
Mucus in the urine is usually owing to the enlargement of 
the prostate gland. Pus in the urine indicates abrasion 
of the bladder, kidneys, or urethra. Bile in the urine in- 
dicates # re-absorption of the bile from the liver, or that 
the liver fails to secrete the bile from the blood. This 
symptom is present in most forms of intermittent fever, 
jaundice, disease of the liver, &c. 

THE FAECES AS INDICATING DISEASE. 

The inspection of alvine evacuations is of great import- 
ance in making up the diagnosis of disease. Where the 
bile is deficient, they are of a light ash color ; if there is 
an excess, they are quite yellow. A red appearance of the 
stools indicates passive congestion ; if red and thin, they 
indicate hyperemia. If they are of a bloody mucous cha- 
racter, inflammation of the colon is indicated. When the 
stools are bloody in typhoid fever, they indicate ulceration 
of the glands of the bowels. When the faeces are very 
thin, and of a rice color, deep capillary congestion is indi- 
cated, as in cholera, cholerine, &c. 



292 DIAGNOSTIC SIGNS. 

The condition of the mind should also be taken into 
consideration in diagnosis. To what extent the mind con- 
trols or influences the morbid tendencies of the body, is 
difficult to determine ; but, that it has a powerful influence, 
not only in increasing the severity of morbid phenomena, 
but also of controlling it, is a fact too apparent 'to every 
observing physician to need comment. The conditions of 
mind, however, which contribute to the amelioration or 
increase of organic disease, are as yet but imperfectly 
understood. Kossuth stated, in one of his addresses 
before the American people, that while lying very low with 
fever, not having been out of bed for a considerable length 
of time, he received very important intelligence, upon 
which he arose, and entered at once upon active duties, 
without feeling any further embarrassment from his disease. 

Instances are of almost daily occurrence, in which pa- 
tients, who have for a long time labored under some low 
chronic disease, hear of a new remedy, which, if taken, 
is sure to remove it ; and if taken at the time when the 
mind is most positive, for a time, at least, all the syxnptoms 
undergo improvement. 

There are other instances of the most violent mental and 
physical agonies being relieved by the supposed virtue im- 
parted to a glass of water or a bread-pill by a clairvoyant, 
or so-called spiritual medium, magnetic passes, &c. These 
things may appear to the novice in observation, absurd ; 
yet they are living facts which must be met and should be 
investigated. This class of cures is not confined to the 
nervous and weak alone ; but the athletic are frequently 
the passive subjects of these mysterious operations of the 
human mind. Even infants, whose minds are not suscep- 
tible of imaginary impressions, are said by the best of 
authority, to have disease controlled by the action of other 
minds. A circumstance was related to me to-day by a 
gentleman of undoubted veracity, of a child while laboring 



DIAGNOSTIC SIGNS. 293 

under a protracted brain affection, being relieved in a few- 
hours by one who claimed to be a spiritual medium. He 
magnetized a glass of water, as he stated, and by giving 
a teaspoonful every five minutes, the child was relieved. 
Another instance was related, of a similar glass of water 
acting as a cathartic in fifteen minutes, although there was 
obstinate costiveness at the time. Mental impressions, as 
affecting disease, have been noticed from the earliest 
history of medicine until the present time. 

The mystic ceremonies of the Esculapians, the incanta-. 
tions of Galen, the rites and ceremonies of Avicenna, 
were another mode of producing the same results. The 
effects of Indian charms, the supposed power of the 
seventh son, of men born with a caul over the face, of 
touching a dead body for the cure of cancers, of taking 
water, in which sugar pills have been placed, are all 
examples of the effect of the mind over the diseases of the 
body. 

While the mind may be thus beneficially directed upon 
diseased organs of the body, it frequently has an opposite 
tendency. It is a familiar fact, that nearly every disease 
that affects the human family, may be, and is occasionally 
induced by a perverted action of the mind upon the body. 
Fevers are frequently caused by a long continued exercise, 
or by powerful emotions, of the mind. 

Phthisis is frequently induced in persons of a consump- 
tive tendency, by constantly anticipating it. Cholera is 
not only induced, but its fatality increased, by the des- 
pondent mind. Disappointments cause loss of appetite, 
fever, changes of the urine, &c. ; diarrhea, pains in the 
head, &c, may be caused by mental impressions. One 
of the most remarkable instances of the influence of the 
mind over the body, in producing morbid changes, is re- 
lated by Dr. Cheyne, of Col. Townsend, who could at any 
time produce all the phenomena of death, not only arrest- 
25* 



294 DIAGNOSTIC SIGNS. 

ing circulation, respiration, &c, but would remain in this 
state for hours, and then by an effort of the will, be re- 
stored to his natural condition. 

He carried his last experiment too far, and it resulted 
in actual death. The limits of this work will not allow me 
to enter further into the investigation of the subject. The 
above facts are sufficient to give some idea of the influ- 
ence of the mind over matter, and the physician who 
would treat disease skilfully, must seek to investigate such 
facts, and as far as possible, to understand their cause and 
study their effects. The condition of the mind, whether 
diseased or healthy, with all its manifestations, should be 
taken into account. The condition of the skin, the tempe- 
rature of the body, the temperament of the patient, his 
peculiar idios}mcrasies, together with his habits of living, 
occupation, external influences, &c, should be considered, 
before he assumes the responsibility of administering medi- 
cine, for the removal of disease. 



A LIST 

OF 

SOME OF THE PRINCIPAL REMEDIES 

USED BY 

THE AMERICAN ECLECTIC PROFESSION, 

ALSO THE METHOD OF 
PREPARING AND USING THE SAME. 



Aconitum Napellus. 

Common name, Monk 7 s-kood. This is an European 
plant. The tincture of the leaves is the preparation mostly 
used by eclectic physicians, in doses of from one to five 
drops, repeated at intervals of from one-half hour to an 
hour. It is used in all fevers and inflammations of an 
asthenic character. It is an active diaphoretic and se- 
dative to the circulation, and at the same time increases 
the nervous forces. There is no remedy known, which 
possesses greater power to arrest typhoid and kindred 
fevers in their incipient stages. In peritoneal inflamma- 
tion, the tincture of Aconite is of the greatest importance, 
frequently controlling the disease in a very few hours. It 
may also be used in dysentery, erysipelas, cerebral con- 
gestion, croup, hooping cough, &c. 

Much care should be observed in.preparing the tincture, 
which should be made from the recently dried leaves, in 
proportion of two ounces of dried leaves to one pint of 
diluted alcohol. After standing fourteen days, it should 
be strained and bottled for use. The active principle of 

(205) 



296 LIST OF REMEDIES. 

the plant is the aconitine, which may be used in all cases 
where the tincture is indicated. It should be triturated, 
one grain to ten of powdered sugar, and one grain of the 
trituration is a dose, repeated as indicated. The proper- 
ties are the same as the tincture. 

Asclepin 

Is the active principle of the Asclepias Tuberosa. 
Common names, White Root, Pleurisy Root, &c. The 
Asclepin is the preparation mostly used. It should be 
triturated, one grain to ten of white sugar. From three 
to four grains is a dose. It is tonic, expectorant, diapho- 
retic and diuretic. It is used in pleurisy, pneumonia, 
phthisis, bronchitis and low forms of fever. The White 
Root is used in the same disease in the form of syrup and 
tincture. 

Apocynin 

Is the active principle of the Apocynum Andro-soemi- 
folium. Common name, Bitter Root. The Apocynin is 
the preparation mostly used. It is diuretic, emetic and 
anthelmintic. It is used in dropsy, dyspepsia, constipa- 
tion, diabetes ; and for worms, congestion of the uterus 
and scrofula. It is used with good effect for worms in the 
rectum. It should be- triturated, one grain to ten of sugar, 
of which three to five grains is a dose. 

Alnuin 

Is the active principle of the Alnus Serrulata. Common 
name, Swamp Alder. 

The Alnuin is the preparation used. It is employed in 
intermittent and remittent fevers, in chronic indurations of 
the liver, in necrosis, cancer, &c. 

It should be triturated, one grain to ten of sugar, and 
from two to three grains given at a dose. 



LIST OF REMEDIES. 29? 



Aletrin 



Is the active principle of the Aletris Farinosa. Common 
name, unicorn, star grass, &c. 

The Aletrin is the preparation mostly used. It is anti- 
periodic, stimulant, nervous, tonic, and is a valuable 
alterative for the uterus, ovaries and kidneys. It is a 
remedy greatly valued in most affections of the uterus and 
kidneys, in irregularities of the menses, prolapsus uteri, 
passive congestion, resulting in leucorrhaea, &c. Also in 
diabetes, and Bright's disease of the kidneys, it may be 
used to much advantage. It is also valuable in most ner- 
vous affections. 

It should be triturated, ten grains to the one hundred ; 
from one to three grains of the trituration is a dose. 

Althcea Officinalis. 

Common name Marshmallow. It is a mucilaginous 
diuretic, and is best used by adding a small quantity of 
the pulverized root to cold water. It should be used in 
all forms of fever in the active stages, and in all diseases 
where a mucilage and diuretic is indicated. 

Amaranthus Hypochondriacus. 

Common name Red Cock's-comb. It is alterative, tonic, 
and astringent ; is mostly used in the form of a warm in- 
fusion, and is beneficial in scrofulous consumption, also in 
diarrhoea, aphthous sore mouth, &c. The close of the 
strong tea is a tablespoonful every half hour. 

Ammonice Hydrochloras. 

Common name, Muriate of Ammonia. It is diuretic, 
stimulant, alterative and resolvent. When triturated, it is 
of much value mixed with Podophyllin, owing to its resolvent 
and alterative powers, breaking down old adhesions, soft- 



298 LIST OF REMEDIES. 

erring indurated livers, operating with great efficiency in 
all cases where such remedies are indicated. It may be 
given in powder or syrup. The dose is from one to ten 
grains every two or three hours. 

Apium Fetroselinum. 

Common name, Parsley. The root is the part mostly 
used, in the form of a strong decoction. It is diuretic, 
aromatic, stimulant, and may be used in dropsies, incipient 
phthisis, retention of urine, &c. 

Apocynum Cannabinum. 

Common name, Indian Hemp. It is hydrogogue, ca- 
thartic, diuretic and nervine. It is used in dropsies, liver 
complaint, bronchitis, scrofula, and is almost a specific for 
neuralgia. The root is the part employed, and as the 
active principles have but just been obtained, a strong de- 
coction is now mostly used. Dose of a strong decoction 
one tablespoonful every half hour. The Hydro-alcoholic 
extract, as prepared by Tilden & Co., may be used in two 
or three grain doses, in the place of the decoction. 

Arnica Montana. 

Common name, Leopard's-bane. This is indigenous to 
the mountainous districts of Europe. It is antiperiodic, 
tonic and stimulant, and in large doses acts as an altera- 
tive cathartic. The tincture is the preparation principally 
employed. It is used in intermittent fevers, in aphthous con- 
ditions of the mucous surface, and in most forms of eruptive 
diseases. Externally, the tincture is used in the form of a 
liniment in all cases of bruises, sprains, &c. A dose of 
the tincture is from five to ten drops every two or three 
hours as an intermittent, and should be used between the 
paroxysms. For ulceration of the mucous surface, the 
dose is from one to five drops three or four times a day. 



LIST OF REMEDIES. 299 

Amjjelopsin 

Is the active principle of the Arnpelopsis Quinquefolia. 
Common name, Woodbine. The Ampelopsin is the pre- 
paration mostly nsed. It is one of our most reliable 
alteratives, acting with great certainty and power upon 
the lymphatic system, removing scrofula, syphilis, and 
mercurial taint, with great promptness. When used for 
syphilis, it should be combined with Iodide of Potassium 
and Phytolaccin. It should be triturated, ten grains to 
one hundred of sugar, dose from five to ten grains. The 
crude article is used in the form of a syrup, for the same 
disease. 

Baptisin. 

This medicine is prepared from the Baptisia-Tinctoria 
(common name, Wild Indigo Weed. Its medical proper- 
ties are antiseptic, emmenagogue, and alterative ; it is one 
of the metastic remedies used in typhoid fever; is also 
used to good advantage in scrofula. As an emmenagogue, 
it is quite efficient, and may be used in all cases where 
such a remedy is indicated. Triturate ten grains, to one 
hundred of sugar, of which from five to ten grains is a 

dose. 

Belladonna. 

Common name, Deadly Xight Shade. The extract is 
the preparation mostly used. It should be triturated, by 
adding one grain of the extract, to one hundred grains of 
White Sugar. Belladonna thus prepared, is a specific for 
simple scarlet fever, and is a valuable remedy in other 
forms of the disease, in connection with Hyclrastin, &c. 
It is also valuable in nervous headache, neuralgia, and 
erysipelas. Dose of the trituration, is from one to three 
grains, diluted in a tablespoonful of soft water. 



300 LIST OF REMEDIES, 

Bryonia Alba. 

Common name, Wild Hops. The extract is the prepa- 
ration mostly used. It should be triturated five grains of 
the extract, to one hundred grains of White Sugar. Thus 
prepared, the Bryonia is used in the advanced stage of 
typhoid fever, malignant dysentery, and the suppurative 
stage of internal inflammation. 

Bebeerine. 

The sulphate of Bebeerine is the active principle of the 
bark from the Bebeeru, a tree which is indigenous to 
India. The Bebeerine is one of the most important anti- 
periodics known ; and by many, it is deemed superior to 
the sulphate of quinine. It is used in intermittent and 
remittent forms of fever. Also in neuralgia, strumous 
ophthalmia, leucorrhcea, intermittent headache, &c. 
Dose, from one to three grains, may be given every two 
or three hours, until forty or fifty grains are taken. It 
may be repeated as often as indicated. 

Bidens Bipinnata. 

Common name, Spanish Needles. A watery infusion 
is the form in which this article is mostly used. It is em- 
menagogue, tonic, and expectorant. It is used in dys- 
menorrhea, amenorrhea ; also in chronic pneumonia, 
jaundice, &c. Dose of the strong infusion is, from one 
to two tablespoonfuls every three or four hours. 

Caulophyllin. 

The caulophyllin is obtained from the Blue Cohosh. It 
is diuretic, diaphoretic, emmenagogue, and tonic. It is 
used in all uterine diseases dependent on debility of that 
organ. It is also used in acute and chronic rheumatism. 



LIST OF REMEDIES. 301 

The caulophyllin should be triturated ten grains, to the 
hundred of white sugar ; from three to five grains of the 
trituration is a dose, repeated as indicated. 

Cerasin, 

The eerasin is prepared from the bark of the cerasus 
virginiana, choke cherry. Properties and use : Cerasin is 
antiperiodic, astringent, and tonic. It is used in inter- 
mittent and remittent fevers, in chorea, spermatorrhoea, 
and dysentery. It should be triturated ten grains, to the 
hundred of sugar, and from five to ten grains given for a 
dose. 

Chelonin. 

The chelonin is obtained from the snakehead or bal- 
mony. Medical properties and use. Tonic and altera- 
tive. It is used in indigestion, hypertrophy of the liver, 
chronic diarrhaea, &c. It is to be triturated ten grains, 
to a hundred of sugar, of which from two to five grains is 
a dose. 

Cornin. 

Obtained from the Cornus Florida or Dogwood, 
Medical properties and use : Antiperiodic and tonic. It 
is used in all cases where quinine is recommended. In 
low forms of fever it is preferable to quinine, on the ac- 
count of its tonic property in connection with its anti- 
periodic. Dose not triturated is from one to three grains. 

Corydalin, 

The corydalin is derived from the Corydalis Formosa. 
Common name, Turkey Pea. This remedy is one of the 
most valuable antisyphilitics known to the medical profes- 
sion. It is also very valuable in the treatment of scrofula 
and eruptive diseases. It should be triturated ten to the 
hundred of sugar, and from one to five grains given at a dose. 
26 



302 LIST OF REMEDIES. 

Cypripedin. 
The cypripedin is prepared from the Lady's Slipper 
or nerve root. Cypripedin is nervine, tonic, and antispas- 
modic. It is used in all nervous and spasmodic diseases. 
In chronic ague, in combination with Cerasin, it is a 
remedy of much value. It is one of the ingredients of the 
intermittent drops. The cypripedin should be triturated 
ten grains to the hundred, and from five to ten grains 
given for a dose. 

Cinchonin. 

Cinchonin is commonly obtained from the pale Peruvian 
Bark. Its medical properties are similar to the quinine, 
and it is used in-all diseases in which the quinine is admis- 
sible, Dose is from three to five grains. 

Collodion. 

Collodion is an ethereal solution of Gun Cotton. It is 

used to form an external protection to abraded surfaces. 

Also as an external application in erysipelas. It should 

be applied with a small sponge and repeated as indicated. 

Cimicifugin. 
The cimicifugin is the same as macrotin. It is the 
active principle of the Cimicifuga Bacemosa. It is a 
tonic, nervine, and antiperiodic. The cimicifugin is very 
extensively used in all uterine affections, in rheumatism, 
chronic ague, &c. It should be triturated ten grains to 
the hundred of sugar before being used. From two to 
ten grains of the trituration is a dose, repeated as indi- 
cated. 

Chinoidine. 

The Chinoidine is one of the active principles of the 
cinchona. It is tonic, antiperiodic and alterative, and is 
used in all cases where Quinine is recommended. By some 
it is supposed to be much better than Quinine, on account 
of its alterative and tonic properties. 



LIST OF- REMEDIES. 303 

Capsicum. 

Cayenne pepper is an active stimulant, and is used to 
great advantage in all low forms of fever, also in chronic 
dyspepsia, &c. Dose from one to five grains. 

Capsicum Oil, 

This is an oleo-resinous substance which contains all the 
active properties of the crude pepper, and is used for the 
same purpose. It should be triturated with white sugar, 
ten grains to the hundred. Dose from three to five grains, 
repeated as often as indicated. 

Digitalin. 

This medicine is derived from the Digitalis Purpurea. 
Common name, Foxglove. Properties and use : The 
digitalin is diuretic, sedative and antiphlogistic. Owing 
to the sedative influence of the digitalin over the heart and 
arteries, together with its almost specific influence over the 
lymphatic system, it is much used in all cases of a febrile 
character, accompanied with an accelerated pulse and an 
obstructed condition of the secretions. It is also used in 
dropsical effusions, asthma, rheumatism, disease of the 
heart, &c. It should be triturated, five grains to the 
hundred of white sugar, and from one to three grains of 
the powder given at a dose. 

Dioscorin. 

The Dioscorin is the active principle of the Dioscorea 
Yillosa, or wild yam. The dioscorin is a specific remedy 
for bilious colic. It is also used in other spasmodic 
diseases. It operates most efficiently by being triturated 
ten grains to the hundred of sugar. The dose of the tri- 
turation is five or ten grains every five or ten minutes, until 
relief is produced. 



304 LIST OF RE ME DIES, 

Euphorbin. 

The Euphorbin is derived from the root of the Euphor- 
bia cor ollata.. Common name, Bowman Root. The Eu- 
phorbin is emetic, cathartic, diaphoretic and expectorant. 
It is used in the forming stage of fever, in dropsy, dysen- 
tery and chronic affections of the liver. As an emetic, 
from one to three grains should be added to one half pint 
of warm ginger tea, and one tablespoonful taken every five 
minutes until it produces free emesis. As an alterative, it 
should be triturated ten grains to the hundred of white 
sugar, and from two to five grains of the trituration given 
as a dose, and repeated three or four times a day. 

Eupurpurin. 

The Eupurpurin is obtained from the Eupatorium Pur- 
pureum. Common name, Queen of the Meadow. The 
Eupurpurin is resolvent, diuretic and stimulant. It is used 
in gravel, strangury, gout, dysentery, scrofula, necrosis, 
cancer, and in chronic affections of the uterus. It should 
be triturated ten grains to the hundred, and from three to 
five grains of the trituration given as a dose. 

Eupatorine. 

The Eupatorine is prepared from the Eupatorium Per- 
foratum, or Boneset. It is antiperiodic, alterative, and 
in large doses emetic and purgative. It is used in all 
diseases where such remedial properties are indicated, such 
as ague, dyspepsia, &c. It should be triturated ten to the 
hundred, and from one to five grains of the trituration is a 

dose. 

Euonymine. 

The Euonymine is obtained fi'om the Euonymus Atro- 
purpureus. Common name, Wahoo. The Euonymine is 
one of the most valuable alteratives known to the profes- 



LIST OF REMEDIES. 305 

sion. Its specific tendency is towards the liver, upon 
which it acts with far more certainty than mercury or any 
other known remedy. It may be used in all chronic affec- 
tions of the liver, and wherever a thorough alterative and 
tonic is indicated. It operates best by being triturated 
with sugar, 100 parts of sugar to 10 of Euooymine. Dose 
from five to ten grains of the trituration. 

E rig era n Philade Iph ic um. 

Common name, Colt's Tail, Rag-weed, &c. Erigerin 
is a concentrated preparation obtained from the plant, and 
is tonic, astringent and diuretic. Like other concentrated 
remedies, it operates best by being triturated with sugar. 
From five to ten grains of the trituration is a dose. The 
volatile oil of Erigeron Philadelphicum is the most valuable 
medical part of the plant. It is anti-hemorrhagic and 
diuretic, used in all cases of hemorrhage, and is a remedy 
of inestimable value. Prof. Sites, who has had very large 
experience with this article, regards it as a specific, in all 
cases of uterine hemorrhage. It is also used in haemop- 
tysis, dysentery, gravel and rheumatism. Dose from five 
to ten drops as often as indicated. 

Elaterin 

The Elaterin is the active principle of the Momordica 
Elaterium. Common name, ivild or squirting Cucumber. 
The Elaterin is a powerful hydragogue cathartic. It is 
used in dropsy, and as a revulsive to some cerebral affec- 
tions. It should never be used without trituration. It 
should be triturated by adding ten grains to the hundred 
of sugar. Dose of the trituration is from one to three 
grains, 

Gelsemin. 

Obtained from the root of the Gelseminum Sempervirens. 
Common name Yellow Jessamine, Woodbine, &c. Pro- 
26* 



306 LIST OF REMEDIES. 

perties and uses : Antiperiodic, antispasmodic and seda- 
tive. It is used in all fevers where there is not congestion 
of the brain. It is also used in pleurisy, pneumonia, 
rheumatism, acute and chronic. The Gelsemin possesses 
great power over the circulation, reducing the pulse from 
a hundred or a hundred and thirty, to sixty or seventy in 
the course of one or two hours. It also excites perspira- 
tion and quiets nervous excitement, hence it has been very 
extensively used in neuralgia. The Gelsemin should be 
triturated ten grains to the hundred of sugar, and from 
one to two grains of the trituration given at a dose. The 
tincture of the crude root is also used in the same diseases. 
Dose of the tincture is from 15 to 20 drops. 

Geranin. 

The Geranin is obtained from the Geranium Maenlatum 
or Crane's Bill. The Geranin is one of the most powerful 
astringents known to the profession, and is used in all 
cases where a vegetable astringent is indicated. It may 
be used with or without trituration. Dose of the triturated 
is from three to five grains ; of the crude, from two to three 
grains is a dose. 

Helonin. 

Obtained from the Helonias Bioica, or Unicorn Root, 
Starwort, &c. The helonin is tonic, diuretic, and ner- 
vine. There is no medicine known, which exerts a more 
salutary influence over the assimilating powers of the 
system, than the helonin. Hence it is an invaluable 
remedy in the treatment of diabetes : it is also used in 
leucorrhsea, and in all cases where passive congestion of 
the uterus appears to be the prominent cause of the ail* 
ment The helonin should be triturated ten grains of 
helonin to one hundred grains of White Sugar. Dose 
from five to ten grains. 



LIST OF REMEDIES. 307 

Hydrastin. 

The hydrastin is obtained from the Hydrastus Cana- 
densis, or Golden Seal. The hydrastin is a pure tonic, 
and appears to operate equally well upon all the tissues of 
the body. Hence it is very extensively used in all low 
forms of fevers, in all cases of debility, &c. A much less 
quantity produces the same effect by being triturated one 
grain to ten. Of the triturated from one to three grains 
is a dose, repeated as indicated. 

Hyosciamin. 

The Hyosciamin is obtained from the Hyosciamus 
Niger, or Henbane. It is anodyne, antispasmodic, and 
laxative. It is used in neuralgia, gout, asthma, phthisis, 
irritability of the urinary organs-, and nervous affections. 
It should be triturated one grain to ten of sugar, and from 
one-half to one grain of the trituration is a dose. 

Irisin. 

The Irisin is obtained from the Iris Versicolor, or Blue 
Flag. It is alterative, purgative, diuretic, and anthel- 
mintic. It is used in syphilis, chronic hepatitis, scrofula, 
rheumatism, &c. The trituration of this remedy is ten to 
the hundred, and from five to ten grains is a dose. 

Jalapin. 

The Jalapin is obtained from the Iponiaea Jalapa, or 
Jalap. The Jalapin is a hydragogue cathartic, and is 
used in dropsy, congestion of the liver, &c. The dose of 
the triturated is from five to ten grains. 

Juglandin. 

The Juglandin is prepared from the Juglans Cinerea, 
or Butternut. It is cathartic and alterative. It appears 



308 LIST OF REMEDIES. 

to exert' most of its influence upon the dermoid tissues, 
where it is used in cutaneous diseases with very happy 
results. It is triturated the same as the other concentrated 
remedies : give it in ten or twelve-grain doses three times 
in the twenty-four hours. 

Leptandrin. 

The Leptandrin is prepared from the Leptandra Vir- 
ginica, Culver's Physic, or Black Root. It is alterative, 
tonic, and hepatic. It is used very extensively as an altera- 
tive to the mucous surface, in inflammation of the glands 
of the bowels, in chronic diarrhsea, and dysentery. 
It is also used in scrofula and chronic bronchitis. The 
leptandrin is to be triturated ten to the hundred, and from 
ten to twenty grains given at a dose. 

Lobelin. 

The Lobelin is obtained from the Lobelia inflata. It is 
emetic, diaphoretic, antispasmodic, and expectorant. The 
lobelin is one of the most valuable medicines in the materia 
medica. It is used in all cases where a remedy possessing 
those properties is indicated. As an antispasmodic, it may 
be used in all cases of convulsions, croup, &c. Also in 
asthma and spasmodic croup. As an emetic, it may fre- 
quently be indicated in the formative stage of fevers, 
dysentery, jaundice, lung fever, &c. As an expectorant, 
it may be used in chronic catarrh, pneumonia, &c. The 
lobelin should be triturated ten to the hundred of sugar, 
of w 7 hich from one to ten grains may be given as an 
expectorant, from ten to forty as an emetic, and from five 
to ten as an antispasmodic. 

Lupulin. 

Lupulin is obtained from the Humulus Lupulus. Com- 
mon name, Hops. The lupulin is tonic, anodyne, and 



LIST OF REMEDIES, 309 

anaphrodisiac, It is used very extensively in all nervous 
diseases in the place of morphine, for which it serves as a 
good substitute ; it is also used in spermatorrhoea and 
chronic gonorrhaea, for which it operates with great effi- 
ciency. For loss of sleep it serves all the purposes of 
morphine. And of late it is becoming quite a popular 
remedy for ague ; and its power over that disease leads 
me to infer it to be quite a strong antiperiodic. It may 
be triturated, and from five to ten grains given as a dose, 
and repeated as indicated. 

Lycopus Virginicus. 

Common name, Bugle weed. It is used with great 
effect in haemoptysis, in diabetes, and phthisis ; it is 
also recommended in leucorrhoea, &c. The preparation 
mostly used is the infusion, which should be made strong, 
and one tablespoonful given at a dose ; to be repeated 
as indicated. 

Myrictn. 

The Myricin is obtained from the Myrica Cerifera. 
Common name, Bayberry. It is astringent and alterative. 
It is used in scrofula, dysentery and follicular stomatitis. 
There are but few remedies which exert a more salutary 
influence over a diseased condition of the mucous surface 
than this. It is also used externally upon indolent ulcers. 
It should be triturated ten grains to one hundred, of which 
from five to ten grains are a dose. When used externally, 
the triturated powder should be sprinkled upon the surface, 
followed by an elm poultice. 

Morphia. 
This article is prepared from opium, and contains its 
narcotic properties. It is used to allay pain and to quiet 
nervous excitement. Although it is a valuable remedy 
when properly applied, it should be used with much cau- 
tion, owing to its paralyzing properties. Dose from one 
sixteenth to one half a grain. 



310 LIST OF REMEDIES. 

Menispermin 

Is the active principle of the Menispermum Canadensis, 
or yellow parilla. It is sialagogue, tonic, alterative, diu- 
retic, and in large doses purgative. It is a remedy of 
great value in the earliest stages of phthisis. It is also 
used in chronic enlargement of the liver and spleen. In 
combination with* other remedies, it is valuable in syphilis, 
scrofula and meningitis. It should be triturated ten grains 
to the hundred, and given in from five to ten grains per 

dose. 

Phytolaccin 

Is the active principle of the Phytolacca Decandria. 
Common names, Poke Root, Garget, Skake Root, &c. 
It is alterative, purgative, diuretic and antisyphilitic. 
This remedy possesses almost specific power over syphilis. 
It is used in tuberculous affections of the liver and spleen ; 
also in cancer and scrofulous cachexia. It is used exter- 
nally for indolent scrofulous ulcers, necrosis and cancers. 
I have found an ointment of this article valuable in 
obstinate hemorrhoids. For internal use it should be tri- 
turated ten grains to one hundred of sugar. In syphilis, 
from three to five grains of the trituration should be given 
three or four times a day. If there should be chancre, a 
small quantity of the untriturated should be spread upon 
it. If this course is persisted in until a constitutional im- 
pression is made by the Phytolaccin, a cure will generally 
be effected. In scrofulous and hepatic diseases, one or two 
grains of the triturated should be given two or three times 
a day. 

Podophyllin. 

This is obtained from Podophyllum Peltatum. Com- 
mon names, May Apple, Mandrake. It is alterative, 
emetic, cathartic and resolvent. The action of Podo- 
phyllin upon the glands is somewhat like the mercurials. 



LIST OF REMEDIES. 311 

When given alone, as a cathartic, its action is very slow, 
requiring from six to twelve hours. As an alterative, it 
is used in all cases of hypertrophy and local congestion. 
It exerts a specific influence over the liver, stimulating it 
to increased secretion of bile. As a resolvent, it is used 
iri adhesive inflammation, following pneumonia, peritonitis 
and pleuritis. It is used to defibrinate the blood in altera- 
tive doses, and as a general stimulant to the absorbents. 
It should be triturated ten grains to the hundred. From 
one to two grains are used as an alterative, and from two 
to five grains acts as a cathartic. 

Populin. 
The Populin is obtained from the Populus Tremuloides, 
or Quaking Aspen. The Populin is tonic, alterative, 
vermifuge and stomachic. It is -used in dyspepsia, cos- 
tiveness, hysteria, &c. It is to be triturated, and from 
three to five grains given as a dose. 

Prunin. 
The Prunin is obtained from the Primus Virginiana. 
Common name, Wild Cherry. It is a tonic expectorant 
and nervous sedative. The Prunin is a remedy well cal- 
culated to act beneficially in the early stage of phthisis, 
and in chronic bronchitis. It has been used lately as an 
antiperiodic with good success. The prunin should be 
triturated, ten of prunin to the hundred of sugar, and from 
five to ten grains given at a dose. 

Ptelin. 

The Ptelin is obtained from the Ptelia Trifoliata. Com- 
mon name, Swamp Dogwood. The Ptelin is tonic and 
stimulant. It is a remedy of much value in diabetes, in 
chronic diarrhasa and indigestion. It should be triturated 
ten parts to the hundred of sugar, and from five to ten 
grains given at a dose. 



312 LIST OF REMEDIES. 

Rhusin. 
The Rhusin is obtained from the Rhus Glabra. Com- 
mon name, Upland Sumach. It is a valuable remedy in 
purpura, scurvy and dysentery. It is also used with good 
effect, as an external remedy, in indolent ulcers and piles. 
For internal use it should be triturated as the other con- 
centrated remedies, and from one to five grains of the tri- 
turation given at a dose. As an external remedy for ulcers 
or piles, it should be made into an ointment with Balsam 

of Fir. 

Rumicin. 

The Rumicin is obtained from the Rumex Obtusifolius, 
or Yellow Dock. It is a remedy of great value in consti- 
tutional cancerous affections, and in scrofula. It should 
be triturated and given in three or four grain doses. 

Sanguinarin. 
The Sanguinarin is obtained from the Sanguinaria Ca- 
nadensis. Common name, Blood Root. The Sanguinarin 
is one of the most valuable remedies known, in the treat- 
ment of pseudomembranous croup. It has proved as much 
of a specific for that disease, as Quinine has for ague. I 
have seen it used in a great number of cases, and have 
never known a single failure. It is also used in pnemonia 
with good effect. As a mild alterative and sedative, it is 
also valuable. . Externally, sanguinarin is used in open 
cancer with good effect. When used for the croup, it 
should be made into an acetic syrup, by adding twenty 
grains of Sanguinarin to four ounces of vinegar; steep 
and add one ounce of sugar to form a syrup. D-ose one 
teaspoonful as often as indicated. As an alterative and 
expectorant, it should be triturated ten grains to the hun- 
dred of sugar, and from three to fiYe grains given at a dose. 
Externally, for cancer, it is mixed with the white of an 
egg, and applied in the form of a paste. 



LIST OF REMEDIES. 313 



Scutellaria. 



The Scutellarin is prepared from the Scutellaria Lateri- 
flora, or Scuilcap. It is one of the most valuable nerve 
tonics and antispasmodics. It is a specific in nervous 
chorea, and very valuable in all other forms of nervous 
affections. It is one of the ingredients of the inter- 
mittent drop. In the low stage of typhoid fever, it allays 
the nervous irritation with great efficiency. I am in the 
habit of using the scutellarin in all cases where I formerly 
used morphine. It should be triturated ten to the hun- 
dred, and given in three or four grain doses. 

Senecin 

Is obtained from the Senecio Gracilis. Common name, 
Life Root. The Senecin is one of the most efficient known 
remedies in irregularity of the menses, and appears to act 
specifically upon the uterus, relieving that organ of con- 
gestion and inaction. From the efficiency with which the 
medicine relieves uterine derangement, its use is mostly 
confined to that class of cases. The dose of the triturated 
is from three to six grains. 

Staphylea Trifolia. 

This medicine is used in the form of a cold infusion. The 
bark of the root is the part mostly employed. It is anti- 
periodic and tonic, and is used in the treatment of inter- 
mittent fever and debility of the stomach. Dose, one or 
two tablespoonfuls of a strong infusion. 

Stillingia Sylvaiica. 

Common name, Queen's Root. The Stillingian is a 
concentrated preparation prepared from the root of the 
Stillingia Sylvatica. This preparation, however, does 
not contain all the active medical properties of the plant. 

27 



314 LIST OF REMEDIES. 

Hence the crude article is mostly used in the form of a 
syrup. The syrup is extensively used in syphilis, scrofula, 
and mercurial diseases. By those who are the most familiar 
with its medicinal properties, it is believed to possess more 
power over mercurial diseases than any other. In order 
to obtain the best effect, its use should be persisted in 
for a considerable length of time. Dose of the simple 
syrup, one teaspoonful three or four times a day. 

Trillin. 

The trillin is obtained from the root of the Trillium 
Pendulum. Common name, Beth Boot. The trillin is 
astringent, styptic, alterative, and tonic. It is used in 
uterine hemorrhage, lencorrhcea, and prolapsus uteri. The 
trillin should be triturated ten grains to the hundred of 
sugar, and from five to ten grains of the trituration is a 
dose. 

Veratrin. 

The veratrin is obtained from the Veratrum Viride. 
Common name, Swamp Hellebore. It is sedative, dia- 
phoretic, alterative, diuretic, and in large doses emeto- 
cathartic. There are but few remedies by which the 
heart's action can be so readily controlled as by this. 
Hence in all sthenic disease in which there is great increase 
of circulation, as in miasmatic fevers, the veratrin consti- 
tute one of the most important remedies in use. In many 
cases of intermittent, remittent, and bilious fevers, the 
vetratrin is the only remedy needed. It is also very 
valuable in the treatment of pneumonia, pleurisy, and 
bronchitis of a sthenic character. But where the powers 
of the system are feeble, and the disease of an asthenic 
character, the veratrin should not be given. As it proves 
too debilitating, a tincture made from the fresh root is 
also used in the same diseases as the veratrin. The 
veratrin should be triturated ten grains to the hundred of 



LIST OF REMEDIES. 315 

sugar, and from one to three grains of the trituration 

given as a dose. Dose of the trituration is from three to 

ten drops. 

Viburin. 

The Viburin is obtained from the Viburnum oxycoccum. 
Common name, High Cranberry. It is antiperiodic, 
tonic, and alterative. The Viburin is a valuable remedy 
in the treatment of ague and remittent fever. It is also 
valuable in periodic pneumonia and pleuritis. While it 
arrests the periodicity of pneumonia, it also facilitates 
expectoration. This remedy has proved highly valuable 
in obviating the casualties of pregnancy. It is frequently 
prepared in the form of a syrup and given under the name 
of mother's relief. When given in the form of a syrup, 
it should be prepared by adding one drachm to the pint 
of the syrup of sugar. Dose, one tablespoonful three 
times a day. Dose of the triturated from three to ten 

grains. 

Xanthoxylin. 

Obtained from the Prickly Ash. The Xanthoxylin is 
one of the most powerful diffusible stimulants known to 
the profession. When given in full doses, it produces 
effects upon the nerves as though slight shocks of elec- 
tricity were passing through the system. From its powerful 
stimulating properties, it is used in all low forms of fever, 
in passive congestion, in cholera, diarrhasa, and dysentery. 
It is also a remedy of great value in congestive chills. It 
should be triturated ten grains to the hundred of White 
Sugar, and from five to ten grains is a dose. A tincture 
is made of the Prickly Ash Berries, by adding an ounce 
of the berries to one pint of brandy. Dose, one teaspoon- 
ful as often as indicated. It is used in the same diseases 
as the Xanthoxylin. 



316 LIST OF REMEDIES, 

Peruvian Bark and its Alkaloids. 

These medicines are without doubt among the most 
precious remedies known to the profession. And the 
prejudice which exists against them, is owing to their 
having been combined with mercury, arsenic, &c, in the 
allopathic practice. The cinchonas and their alkaloids 
are as innocent remedies, when properly used, as any other 
vegetable medicines. The active principles of the Peru* 
vian Bark are Quinine, Cinchonin, Chinoidin, and Qui- 
noidine. The medical properties of all these are very 
nearly the same, although the Quinine is much the strongest. 
They are all antiperiodics, and may be used in all cases 
where a periodicity is a symptom of the disease. Dose 
of the Quinine is from one to ten grains, of the other 
alkaloids from five to twenty grains, 

Gossypium Herbaceum . 

Commonly called Cotton Root, The hydro-alcoholic 
extract is the preparation mostly used. It is emmena- 
gogue and antiperiodic. This extract is extensively cir- 
culated as a quack medicine for producing abortion. It 
is prepared in the form of pills. It is used in chlorosis, 
amenorrhea, dysmenorrhea, and in periodic diseases. 
Dose of the extract is from three to five grains. 

The limits of this work will not permit me to further 
consider each separate remedy. I will therefore refer the 
reader to the American Electic Dispensatory, by John 
King, M. D., where all the resources of American Eclectic 
Physicians are fully considered. Formulae for a few Eclectic 
compounds, will be given. 



LIST OF REMEDIES. SI T 

Mother's Cordial, 

Or Compound Syrup of Partridge Berry, according to 
the American Eclectic Dispensatory. Take Partridge 
Berry, one pound, Helonias Root, High Cranberry Bark, 
Blue Cohosh Root, of each four ounces. Grind and mix 
the articles together, place the whole in a convenient 
vessel, cover them with fourth-proof brandy, and macerate 
for three days. Then transfer the whole to a displace- 
ment apparatus, and gradually add Brandy until three 
pints of spirituous tincture have been obtained, which 
reserve. Then continue the displacement with Hot Water 
until the liquid passes tasteless, add to this two pounds of 
Refined Sugar, and evaporate by a gentle heat to five pints, 
remove from the fire, add the reserved three pints Spiritu- 
ous Tincture, and flavor with essence of Sassafras. This 
preparation, says Dr. King, is a uterine tonic and anti- 
spasmodic. It may be used in all cases where the func- 
tions of the internal reproductive organs are deranged, 
as in amenorrhea, dysmenorrhea, menorrhagia, leucor- 
rhcea, and to overcome the tendency to habitual abortion. 
The dose is from one to four tablespoonfuls three times a 
day ; pregnant females, especially those of a delicate or 
nervous system, will find an advantage in taking one or 
two doses daily. 

Neutralizing Cordial, 

Or Compound Syrup of Rhubarb and Potassa. Take of 
India Rhubarb and Bicarbonate of Potassa each one pound, 
good brandy one gallon, tincture the Rhubarb and Potassa 
for fourteen days, then express the tincture by pressure. 
Add the dregs to one gallon of water, and evaporate clown 
to one half gallon ; strain the liquor, and w r hile it is hot 
dissolve in it four pounds of white sugar. After it gets 
cool, add six ounces of good peppermint essence. This 
27* 



318 LIST OF REMEDIES. 

syrup is a valuable medicine in diarrhsea, dysentery, flatu- 
lency, and most chronic irregularities of the bowels. Dose 
is one teaspoonful repeated as often as indicated. 

Antiscrofulous Syrup. 

As prepared according to the Eclectic Dispensatory. 
Take Yellow Dock Root two pounds, bark of the root of 
False Bittersweet one pound, bark of American Ivy, Am 
pelopsis Quinquefolia, and Figwort, of each half a pound, 
refined sugar sixteen pounds ; grind and mix the drugs 
together, place the whole five pounds in a convenient vessel, 
cover them with alcohol of 16 per cent., and macerate for 
two days. Then transfer the whole to a common displace- 
ment apparatus, and gradually add hot water until two 
pints have been obtained, which retain and set aside. 
Then continue the percolation, and of the second solution, 
reserve so much as contains a sensible amount of spirits, 
and evaporate the alcohol from it. Continue the displace- 
ment by hot water until the solution obtained is almost 
tasteless, and boil down this weaker infusion till it begins 
to thicken, or until when added to the balance remaining 
of the second portion after the evaporation of the alcohol, 
it will make twelve pints. To these two solutions com- 
bined, add sixteen pounds of refined sugar, and by heat 
dissolve, carefully removing the scum which arises as it 
comes to the point of boiling. Then, if it exceeds that 
quantity, evaporate the syrup with constant stirring to 
fourteen pints, remove from the fire, and when nearly cold 
add the two pints of tincture first obtained, and make two 
gallons of syrup. Each pint will contain the virtues of 
four ounces of the ingredients. It may be flavored with 
essence of wintergreen. It is used in all cases where an 
alterative is indicated in chronic hepatitis, rheumatism, 
syphilis, scrofula, cutaneous diseases, ulcers, white swell- 



LIST OF REMEDIES. 319 

ing, rickets, necrosis, and every taint of the system. Dose 
from a teaspoonful to a tablespoonful three or four times a 
day. 

Syrup of Siillingia. 

U Queen's Root 3 ft). 

Prickly Ash Berries 1 J ft). 

1. Grind and mix the articles together, place the whole 
four pounds and a half in a convenient vessel, cover them 
with alcohol of 76 per cent., and macerate for three days. 
Then transfer the whole to a displacement apparatus, and 
gradually add alcohol until five pints of the alcoholic tinc- 
ture have been obtained, which retain and set aside. 

2. Continue the percolation, and of this second solution 
reserve as much as contains a sensible amount of spirits, 
and distil or evaporate the alcohol from it, 3. Continue 
the displacement by hot water until the solution obtained 
is almost tasteless, and boil down this weak infusion until 
when added to the second solution after the evaporation 
of its alcohol it will make twenty -four pints. 4. To these 
two solutions combined, add thirty-two pounds of refined 
sugar, and dissolve it by heat, carefully removing any scum 
which arises as it comes to the point of boiling, and if it 
exceeds twenty-eight pints, evaporate to that quantity with 
constant stirring. Then remove from the fire, and when 
nearly cold, add the four pints of reserved alcoholic tinc- 
ture, and make four gallons of syrup, each pint of which 
will be equal to four ounces of the ingredients in medicinal 
virtue. This syrup is one of the most powerful alteratives 
known. It is used in all cases of syphilis, scrofula, mer- 
curial and glandular diseases. Dose one teaspoonful three 
or four times a day. (This syrup is prepared according to 
the formula of the American Eclectic Dispensatory, 
John King, M. D.) The above formula is the best 
method of preparing the syrup of stillingia, and by 



320 LIST OF REMEDIES. 

tincturing and carefully boiling, the strength may be ob- 
tained, and the syrup prepared and used as directed. For 
domestic practice, however, these syrups can be bought 
already prepared, as most druggists keep them for sale. 

Acetic Syrup of Sanguinaria, or Blood Boot. 

R Blood Root in powder 31. 

Acetic Acid, or Vinegar J pt. 

Water J pt. 

Add the blood root to the vinegar and water mixed, 
and steep for two hours, then strain and add three pounds 
of white sugar. Simmer until a syrup is formed. This 
is the specific remedy for pseudo-membranous croup. It 
is also used in infantile pneumonia and bronchitis. Dose 
for croup is from one-half teaspoonful to one tablespoonful ; 
but it should not be given in quantities sufficient to pro- 
duce vomiting, unless there is imminent danger of suffoca- 
tion ; and then only sufficient to eject the mucus, adhering 
to the upper part of the bronchi and trachea. 

Syrup of Marshmallow. 

R Pulv. Marshmallow , giij. 

Warm Water 1 qt. 

Add the marshmallow to the water and simmer for half 
an hour, or until the water is evaporated to one pint, then 
strain, and add three pounds of white sugar and form a 
syrup. This syrup is mucilaginous and diuretic. Four 
ounces of syrup of marshmallow, and one drachm of 
Iodide of Potassium, make a preparation of great value 
in empyema and dropsical effusions. Dose of the simple 
syrup, one tablespoonful every three or four hours, of the 
Syrup and Iodide of Potassium, one teaspoonful three 
times a day. 



LIST OF REMEDIES, :> l M 

Compound Syrup of Stillingia, 

Be Take Stillingia Root, Root of Turkey Cora, 

each 2 Jb. 

Blue Flag Root, Elder Flowers, and Pipsis- 
sewa leaves each 1 lb. 

1. Grind and mix the articles together, place the whole 
seven pounds in a convenient vessel, cover them with 
alcohol fef 16 per cent, and macerate for three days. 
Then transfer the whole to a displacement apparatus, and 
gradually add hot water until four pints of the alcoholic 
tincture have been obtained, wiiich retain and set aside. 

2. Then continue the percolation, and of this solution, 
reserve as much as contains a. sensible amount of spirit, 
and distil or evaporate the alcohol from it. 3. Continue 
the displacement by hot water, until the solution obtained 
is almost tasteless, and boil this weaker infusion, until 
w T hen added to the sound solution after the evaporation 
of its alcohol, it will make twenty-four pints. 4. To 
these two solutions combined, add thirty-two pounds of 
refined sugar, and dissolve it by heat, carefully removing 
any scum which arises as it comes to the point of boiling, 
and strain. When nearly cold add the four pints of re- 
served Alcoholic tincture, and make four gallons of syrup. 
Properties and use : The Compound Syrup of Stillingia 
is one of the most powerful and effective alteratives, and 
is extensively used by Eclectic practitioners in all cases of 
syphilis, scrofula, osseous, mercurial, hepatic, and glandular 
diseases, or in every case where an alterative is indicated. 
It is most commonly given with one ounce of Iodide of 
Potassium to each pint of syrup. The dose is a fluid 
drachm three or four times a day (American Eclectic 
Dispensatory, by John King, M. D.). 



322 LIST OF REMEDIES. 

Syrup of Alum. 

U Take of Pulverized Alum gi. 

Water 1 pint. 

Heat the water until the alum is all dissolved, and add 
one pound of refined sugar, simmer until a syrup is formed, 
strain, and when it is cool it is fit for use. The syrup of 
alum is very valuable in hooping cough, in chronic catarrh, 
and the early stage of pulmonary consumption. *It is also 
used in leucorrhoea and diabetes. Dose is from one to 
two teaspoonfuls three times a day as often as indicated. 

Pulmonary Balsam. 

Take of the Roots of Spikenard, Elecampane, Comfrey 
and Blood Root, of the leaves and flowers of Hoarhound, 
and of the bark of Wild Cherry, each one pound. These 
may all be ground and tinctured by adding alcohol, water 
and sugar, sufficient to make three gallons of syrup. Or 
any portion of the above compound may be tinctured in 
sufficient alcohol to cover them, when the drugs may be 
boiled until the strength is obtained, and the tincture and 
watery infusion may be mixed, and a sufficient amount of 
refined sugar added to make a thick syrup. The Pulmo- 
nary Balsam is one of the most valuable cough and expec- 
torant syrups in use. It may be used in all cases of coughs 
and colds, also in bronchial and pulmonary affections. 
Dose is from one to two teaspoonfuls four or five times a 
day. 

Bronchitis Drops. 

Take the fluid extract of Rumex Crispus, Rhus Glabra, 
Hyosciamus Niger, Uvularia Perfoliata, and Cypripedium 
Pubescens ; mix well together. The Bronchitis drops are 
valuable in chronic Bronchitis, Laryngitis, &c. Dose from 
five to ten drops, repeated as indicated. 



LIST OF REMEDIES. 323 

Antibilious Physic. 

Hi Take Pulveriz-ed Senna 1 lb. 

Jalap J ft). 

Ginger 1 §. 

Mix. This mixture forms one of the most valuable purga- 
tives in use. It is mild, yet efficient, and is well adapted to 
evacuate the stomach and bowels, whenever it is indicated. 
Dose five or ten grains every two or three hours until it 
operates. 

Worm Mixture. 

U Take Santonin ...f, 10 grs. 

Podophyllin 2 grs. 

Populin , 10 grs. 

White Sugar 30 grs. 

Mix and triturate thoroughly, and bottle for use. Dose 
for a child from one to three grains every night on going 
to bed. The above mixture seldom fails to remove worms 
in children. 

Lac tin. 

Lactin is the sugar of milk, and is very extensively used 
by some physicians to triturate their medicines with ; but I 
have not been able to discover any advantage in the use 
of the lactin, over pure white sugar. 



THE 

DIFFERENT SYSTEMS OF PRACTICE. 



That the reader may become familiar with the resources, 
not only of the American Eclectic System of Practice, but 
also with the practice of the Allopathist, Homoeopathist 
and Hydropathist, I will here introduce a list of diseases, 
with their remedies, from the most approved authority of 
each system of practice. The Allopathic treatment I 
have given strictly according to Prof. Eberle, one of the 
most popular authors upon that system of practice. The 
Homoeopathic practice is given according to J. Lourie, 
M. D., an author of great popularity among Homceopa- 
thists. The size of the dose and the trituration are given 
according to Jahr-s and Gruner's Homoeopathic Pharma- 
copoeia. The Hydropathic treatment is given according to 
Shew, Trail, and other standard authorities. 

ALLOPATHIC PRACTICE. 

Intermittent Fever. — Treatment : — Emetics, opium 
blood-letting, nitre, camphor, sulphuric ether, magnesia, 
calomel and jalap, cinchona, quinine, potash, cloves, 
leeches, blisters, arsenic, sulphate of zinc, black pepper 
salivation. 

Remittent Fever. — Treatment : — Blood-letting, cathar- 
tics, calomel and jalap, ipecac, nitre, salivation, epsom 
salts, castor oil, magnesia, opium, antimony, ammonia, 
cold water, leeches, blisters, balsam copaiva, sinapisms, 
warm bath, enemas, lemonade, quinine, gentian, serpen- 

taria. 

(324) 



ALLOPATHIC PRACTICE. 325 

Yellow Fever. — Treatment: — Blood-letting, calomel, 
salivation, enemata, epsom salts, sponge with cold water, 
leeches, blisters, aperients, diaphoretics, quinine, wine, 
ammonia. 

Synocha or simple continued Fever. — Treatment: — 
Blood-letting, purgatives, soda, magnesia, antimony, jalap, 
cream of tartar, calomel, diaphoretics, nitre, James's 
powders, digitalis, salivation, ipecac, sponging with cold 
water, blisters, cupping, leeches, enemata. 

Synochus Fever. — Treatment : — The same as synocha 
throughout. 

Typhus Fever. — Treatment : — Emetics, ipecac, calomel, 
gentle purgatives, castor oil, enemata, epsom salts, croton 
oil, salivation, blood-letting, effusions of cold water, 
diaphoretics, laudanum, nitre, wine, ammonia, camphor, 
opium, quinine, blisters, capsicum; serpentaria, camomile. 

Glossitis, inflammation of the tongue. — Treatment : — 
Blood-letting, leeches, scarifying, incisions with scalpel, 
laxative enemata, blisters on the back of the neck. 

Tonsillitis, Quinsy,' — Treatment : — Blood-letting, scari- 
fying the tonsils, cupping, an active purge, mild aperients, 
calomel, enemata, nitre, antimony, ammonia, liquorice, 
blisters, spirits turpentine, emollient poultices. 

Parotitis, Mumps. — Treatment: — Keep the bowels 
open, diaphoretics, blisters, mercurial ointment, camphor, 
rubefacient liniments. 

Acute Gastritis. — Treatment : — Blood-letting, leeches, 
blisters, mercurial ointment, mucilaginous drinks, vegetable 
acids, laxative enemata, opium, calomel. 

Chronic Gastritis. — Treatment : — Leeching or cupping, 
blisters, tartar emetic ointment, sulphate of iron, hyoscia- 
mus, morphia, nitrate of silver, borax, Dover's powder, 
balsam of copaiva, syrup of poppies, purgative enemata. 

Peritoneal Enteritis. — Treatment : — Blood-letting, pur- 
gatives, laxative enemata, calomel, castor oil, opium, 
28 



326 ALLOPATHIC PRACTICE, 

spirits turpentine, blisters, emollient poultices, digitalis, 
wine. 

Dysentery. — Treatment : — Bleeding, purgatives, castor 
oil, calomel, laudanum, emetics, ipecac, diaphoretics, sali- 
vation, mucilaginous liquids, nitrous acid, sugar of lead, 
leeches, blisters, emollient poultices, balsam of copaiva, 
turpentine, enemata, dogwood bark, diet, rice, barley. 

Chronic Enteritis. — Treatment: — Proper diet, castor 
oil, laudanum, leeches, blisters, tartar-emetic ointment, 
calomel, balsam of copaiva, spirits turpentine, sulphate 
of iron, nitrate of silver, hyosciamus, elm bark. 

Acute Peritonitis. — Treatment : — Blood-letting, leeches, 
emollient poultices, active cathartics, castor oil, spirits 
turpentine, cream of tartar, calomel, jalap, blisters, 
leeches, salivation, opium, digitalis, wine. 

Chronic Peritonitis. — Treatment: — Leeches, blisters, 
mercurial ointment, tartar-emetic ointment, emollient poul- 
tices, warm baths, castor oil, cream of tartar, Dover's 
powder. 

Acute hepatitis. — Treatment : — Blood-letting, mercury, 
castor oil, leeches, salivation, blisters, opium, antimony, 
warm bath, nitro-muriatic acid, cicuta, tonic bitters, nitric 
acid, extract of conium. 

Chronic hepatitis. — Treatment : — Blood-letting, mer- 
cury, leeches, salivation, blisters, emollient poultices, blue- 
pill, conium, laxatives, epsom salts, gentian, columbo, 
nitro-muriatic acid, white precipitate, setons. 

Splenitis. — Treatment : — Blood - letting, purgatives, 
counter-irritants, warm bath, leeches, tartar-emetic, mer- 
cury, setons, hyosciasmus, diaphoretics, antimony, muriate 
of ammonia, ipecacuanha, iodine. 

Phrenitis, phrensy. — Treatment : — Blood-letting, 
leeches, cold water or ice, active purgatives, calomel, 
senna, blisters, nitre, antimony, digitalis. 

Arachnitis, hydrocephalus. — Treatment : — Laxatives, 



ALLOPATHIC PRACTICE. 327 

calomel, blue-pill, castor oil, blood-letting", leeches, manna, 
laxative enemata, spigelia, ipecac, salivation, mercurial 
ointment, blisters, ice, tartar-emetic ointment, James's and 
Dover's powder. 

Cerebritis, softening of the brain. — Treatment : — 
Blood-letting, sinapisms, opium, cold to the head, blisters, 
calomel, salivation. 

Peripneumonia. — Treatment : — ■ Bleeding, leeches, 
digitalis, nitre, castor oil, emetics, cooling diaphoretics, 
muriate of ammonia, antimony, calomel, opium, camphor, 
ipecacuanha, expectorants, blisters, squills, tartar-emetic 
ointments, setons, conium. 

Cynanche Laryngea, Laryngitis. — Treatment : — Blood- 
letting, leeches, blisters, emollient poultices, emetics, calo- 
mel, sinapisms to the feet, lunar caustic, alum, bron- 
chotomy. 

Cynanche Trachealis, Croup. — Treatment : — Bleed- 
ing, blisters, emetics, warm bath, mercurial purgatives, 
antimony, enemata, salivation, ipecac, friction with turpen- 
tine, polygala senega. 

Acute bronchitis. — Treatment : — Blood-letting, ene- 
mata, castor oil, emetics, tartar-emetic, ipecacuanha, 
squills, expectorants, opium, calomel, blisters, leeches, 
emollient poultices, warm bath, columbo, gentian. 

Chronic Bronchitis, Bronchial Consumption. — Treat- 
ment : — Bleeding, leeches, warm climate, tartar-emetic 
ointment, emollient poultices, emetics, digitalis, antimony, 
squills, balsam copaiva, quinine, opium, conium, ipecac, 
prussic acid, sugar of lead, blue-pill, or calomel, saliva- 
tion. 

Pthisis Pulmonalis. — Treatment : — Blood-letting, digi- 
talis, tartar-emetic blisters, issues and setons, gum arabic, 
prussic acid, acetate of lead, opium, uva ursi, expectorants, 
muriate of ammonia, tartar-emetic ointment, salivation, 
squills. 



328 ALLOPATHIC PRACTICE. 

Nephritis. — Treatment : — Blood-letting, cupping or 
leeches, active cathartics, calomel, castor oil, enemata, 
emollient poultices, blisters, diaphoretics, antimony, steam 
bath, Dover's powder, uva ursi, opium, conium, lime 
water, balsam copaiva. 

Cystitis. — Treatment : — Bleeding, leeches, emollient 
poultices, gentle laxatives, enemata, opium, introduction 
of catheter, steam bath, antimony, calomel. 

Chronic cystitis. — Treatment : — Cupping, leeches, 
blood-letting, castor oil, magnesia, caustic issues on the 
thigh, m'uriated tincture of iron, beech leaves, uva ursi, 
ursi, elm bark injected into the bladder. 

Hysteritis. — Treatment: — Bleeding, leeches, emollient 
poultices, calomel, epsom salts, injecting warm emollient 
fluids into the vagina, blisters, nitre, antimony, opium. 

Chronic hysteritis. — Treatment : — Blood-letting, cup- 
ping, purgatives, leeches, blisters, emollient injections, 
warm bath, mercury, camphor, antimony, balsam copaiva, 
muriate of ammonia, liquorice. 

Pericarditis. — Treatment : — Calomel, bleeding, opium, 
salivation, leeches, blisters, cream of tartar, diuretics, 
squills, pustulation with tartar-emetic ointment, or a caus- 
tic issue over the region of the heart. 

Acute Rheumatism. — Treatment : — Blood-letting, pur- 
gatives, calomel, epsom salts, emetics, antimony, opium, 
diaphoretics, salivation, quinine, colchicum, magnesia, 
stramonium, leeches, blisters. 

Chronic Rheumatism. — Mercury, rhubarb, quinine, 
antimony, salivation, sarsaparilla, vapor bath, sulphate of 
zinc, stramonium, colchicum, arsenic, leeches, cups, blis- 
ters, spirits turpentine, capsicum, camphor, warm bath. 

Gout. — Treatment: — Bleeding, cathartics, calomel, 
emetics, ipecac, opium, eupatorium perfoliatum, colchicum, 
magnesia, blue pill, camphor, ginger, savin, laudanum, 
sinapisms, enemata, cupping, leeching. 



ALLOPATHIC PRACTICE. 329 

» 

Catarrhal Ophthalmia. — Treatment : — Scarifying, anti- 
mony, calomel and jalap, emollient applications, opium, 
solution of zinc, nitrate of silver, corrosive sublimate, 
ipecac, blisters, lunar caustic, quinine, bark, arsenic. 

Rheumatic Ophthalmia. — Treatment : — Bleeding, anti- 
mony, opium, calomel, Dover's powder, blisters, cupping, 
puncturing the cornea, aqueous solutions of opium. 

Purulent Ophthalmia. — Treatment : — Blood-letting, 
leeches, decoction of poppy-heads, calomel, ipecac, anti- 
mony, castor oil, blisters, emollient fomentations, lime, 
nitrate of silver, quinine, nitric acid. 

Scrofulous Ophthalmia. — Treatment : — Leeches, pur- 
gatives, calomel, castor oil, rhubarb, emetics, antimony, 
Dover's powders, sarsaparilla, quinine, barytes, iodine, 
nitrate of silver. • 

Syphilitic and strumous iritis. —Treatment : — Mercury, 
antimony, jalap, salivation, belladonna, precipitate oint- 
ment, chalk, quinine, setons in the nape of the neck. 

Variola, Small-pox. — Treatment : — Blood-letting, pur- 
gatives, calomel, emetics, diaphoretics, nitre, antimony, 
ammonia, cooling regimen, wine, camphor, quinine, opium, 
blisters, scarifications, chalk, ipecac, warm bath. 

Rubeola, Morbilli, Measles. — Treatment : — Mild laxa- 
tives, diaphoretics, sage, elder blossoms, balm, eupatoriurri, 
bleeding, antimony, nitre, warm baths, stimulating friction, 
sinapisms, camphor, ammonia, opium, blisters, calomel, 
squills, serpentaria. 

Scarlatina. — Treatment: — Gentle aperients, cool or 
tepid drinks, emetics, brisk mercurial purges, warm baths, 
nitre, antimony, ammonia, sulphuric acid, cold water to 
the surface, blisters, blood-letting, camphor, calomel, opium, 
sinapisms, wine, quinine, capsicum, enemata, serpentaria. 

Erysipelas. — Treatment : — Blood-letting, purgatives, 
calomel, emetics, diaphoretics, antimony, ipecacuanha, 
magnesia, castor oil, warm bathing, bark, wine, opium, 
28 * 



830 ALLOPATHIC PRACTICE. 

camphor, capping, blisters, enemata, corrosive sublimate, 
nitrate of silver, incisions in the inflamed skin. 

Herpes Phlyctenodes. — Treatment : — Gentle aperients, 
simple diet, diaphoretics, calomel, ipecac, warm bath, 
bleeding, Dover's powder, lunar caustic. 

Herpes Lahialis.- — Treatment : — Fomentations of white 
poppy-heads, acetate of lead. 

Herpes Preputialis. — Treatment: — A solution of borax, 
nitrate of silver, chloride of sodium in solution. 

Pemphigus. — Treatment: — Mild laxatives, rest, tepid 
bathing, bleeding, diuretics, calomel, Fowler's arsenical 
solution, opium, quinine, sulphuric acid. 

Urticaria, Nettle Bash, — Treatment : — Emetics, ipecac, 
mild laxatives, simple diet, cooling drinks, rest, magnesia, 
quinine, sulphuric acid, iron, Fowler's solution, tepid bath. 

Miliaria, Miliary Fever. — Treatment : — Ipecac, emetics, 
warm bathing, diaphoretics, Dover's powder, ammonia, 
serpentaria, camphor, opiates. 

Lichen.— Treatment : — Tepid bathing, mild aperients, 
diluent acidulated drinks, cream, calomel, unsalted butter, 
sulphuric acid, bleeding, Fowler's solution, laxatives, low 
diet. 

Eczema. — Treatment : — Sulphur ointment, tepid bath- 
ing, mild laxatives, nitre, tartar emetic, Dover's powders, 
calomel, nitric acid, soda, sarsaparilla, camphor, opium, 
stramonium, borax, eantharides, arsenic, Fowler's solu- 
tion. 

Herpes Zoster. — Treatment :— Gentle aperients, simple 
diet, diaphoretics, calomel, ipecac, warm bath, bleeding, 
Dover's powders, lunar caustic. 

Herpes Circinatus, Ring Worm.. — Treatment : — Alka- 
line washes, sulphate of copper or zinc, ointment of narrow- 
leafed dock, mild laxatives. 

Erythema. —Treatment : — Light diet, gentle diapho- 



ALLOPATHIC PRACTICE. 331 

retics, mineral acids, warm baths, tepid ablutions, borax, 
acetate of lead, opium. 

Roseola. — Treatment: — Rest, mild aperients, acidulated 
cooling diluents, simple diet, refrigerant diaphoretics. 

Hemorrhagica Petechialis. — Treatment : — Tonics, cin- 
chona, serpentaria, sulphuric acid, wine, nitrate of silver, 
spirits of turpentine, blood-letting, purgatives, calomel and 
jalap, oil of turpentine, bathing the surface with a decoc- 
tion of oak bark. 

Hemorrhages. — Treatment : — Blood-letting, digitalis, 
cold, blisters, sinapisms, warmth, sugar of lead, alum, 
muriated tincture of iron. 

Epistaxis. — Treatment: — Bleeding, cool drinks, laxa- 
tives, nitre, cold water applied to the head, neck and 
genital organs, sugar of lead, gallic acid, blisters to the 
nape of the neck, pediluvium, sinapisms to the feet. 

Hcematemesis, bleeding at the stomach. — Treatment : — 
Blood-letting, sinapisms to the epigastric and hypocondriac 
regions, cupping, warm bath, laxatives, enemas, active 
purgatives, emetics of ipecac, sugar of lead, spirits of tur- 
pentine, castor oil, tincture of iron, juice of the common 
nettle. 

Hcematuria, bleeding of the urinary organs. — Treat- 
ment: — Bleeding, warm bath, opium, cupping, sugar of 
lead, sinapisms over the kidneys, muriated tincture of iron, 
mucilaginous drinks, alum, ipecac, decoction of logwood, 
cold water to the genitals, inject cold solutions of the 
sugar of lead. 

Hcemoptysis, bleeding at the lungs. — Treatment: — 
Blood-letting, common salt, sugar of lead, sinapisms to 
the breast, cooling drinks, laxative enemata, nitrate of 
potash, opium, calomel, emetics, capsicum, digitalis, caustic 
issue-s, setons, leeches to the anus, camphor, ipecac, can- 
tharides, warm hip bath. 

Menorrhagia, uterine hemorrhage. — Treatment: — 



332 ALLOPATHIC PRACTICE. 

Bleeding, sugar of lead, ipecac, opium, camphor, cinna- 
mon, alum, nitre, astringent injections into the vagina, 
elixir of vitriol, tampons, emetics, valerian prussiate of 
iron, ergot, savin. 

Phlegmasia Dolens. — Treatment : — Blood - letting, 
leeches, purgatives, magnesia, colchicum, antimony, calo- 
mel, opium, ipecac, nitre, frictions with dry flannel, fomen- 
tations with hot vinegar and water. 

Apoplexy. — Treatment: — Copious blood-letting, cold 
water to the head, fomentations, sinapisms of the tincture 
of capsicum to the feet, cupping, active purgatives, calomel 
and colocynth, croton oil, castor oil and turpentine, ene- 
mata, aloes, antimony, emetics, zinc, blisters, issues. 

Hemiplegia, palsy of one side ; Paraplegia, palsy of 
the legs. — Treatment: — Blood-letting, purgatives, salts, 
aloes, calomel, scammony, colocynth, capsicum, emetics, 
blisters to the neck, sinapisms to the ankles, stimulating 
enemata, friction, stimulating baths, electricity, galvanism, 
strychnine, salivation, iodine, warm bath. 

Epilepsy. — Treatment : — Bleeding, cold water in large 
draughts, emetics in large draughts, emetics of ipecac, 
calomel, diaphoretics, warm bath, antimony, camphor issues, 
setons, emetics, spirits of turpentine, castor oil, oil of tur- 
pentine, misletoe, oxide of zinc, nitrate of silver, tin, 
lead. 

Catalepsy. — Treatment: — Sulphuric ether, stimulating 
applications to the feet, enemata, bleeding, purgatives, 
galvanism, electricity, country air, regular exercise, tepid 
bathing, blue pill, camphor, tepid shower bath, zinc, vale- 
rian, musk, castor, opium. 

Chorea, St. Vilus-s Dance. — Treatment : — Purgatives, 
mercury, quinine, aloes, bleeding, vegetable diet, Dover's 
powder, magnesia, valerian assafoetida, hyoscyamus, cam- 
phor, opium, turpentine, warm pediluvium, blisters, savin, 



ALLOPATHIC PRACTICE. 333 

iron, leeches and warm bath, sulphur, issues, tartar-emetic 
ointment, &c. 

Convulsive affections of infants.— Treatment :— Emetics 
of ipecac, purgatives, enemata, infusions of savin and 
spigelia, bleeding, calomel, pediluvium, cold water to the 
head, blisters, assafcetida, musk, opium, Dover's powder, 
warm bath, setons, issues, sulphur. 

Hysteria. — Treatment: — Bleeding, sinapisms, emetics, 
sulphate of zinc, ipecac, opium, assafcetida, musk, sul- 
phuric ether, castor, enemata, warm pediluvium, turpentine, 
enemata, camphor, valerian, ictodes-foetida, antimony, 
iron, mercury, cold shower bath, &c. 

Puerperal Convulsions. — Treatment : — Blood-letting, 
sinapisms to the feet, purgative enemata, cupping, cold 
applications to the head, active cathartics, calomel, jalap, 
aloes. 

Tetanus. — Treatment : — Bleeding, leeches, mercury, 
opium, warm bath, purgatives, castor oil, spirits of tur- 
pentine, wine, prussic acid, cold effusions. 

Hydrophobia. — Treatment : — Local applications to 
the wound, wash the wound with warm water, excision, 
cautery, cupping, glysters, ligatures, belladonna, water 
plantain, vinegar, cantharides, mercury, cold bathing, 
copious bleeding. 

Monomania. — Treatment : — Blood-letting, leeches, pur- 
gatives, mercury, castor oil, ^alap, spigelia, turpentine, 
emetics, regimen, exercise, warm bath, cold bath, blisters, 
circular swing, music. 

Delirium Tremens. — Treatment: — Opium the sheet 
anchor, castor oil, laxatives, enemata, cupping, emetics 
of tartar-emetic, ipecacuanha, cold and tepid effusions, 
ammonia, assafcetida, camphor, Hoffman's anodyne. 

Neuralgia. — Treatment: — Divide the nerve with a 
scalpel, quinine, arsenic, carbonate of iron, stramonium, 
frictions with the extract of belladonna, oil of turpentine, 



334 ALLOPATHIC PRACTICE. 

moxa, leeches, strong magnet, lobelia, zinc, leeches to the 
anus, aloes, 

Amaurosis. — Treatment : — Bleeding, free purging with 
calomel, epsom salts, antimony, salivation, belladonna, 
blisters or setons on the neck, leeches to the temples, blue- 
pill, ipecac, sarsaparilla, arsenic, bark, cold bath, capsi- 
cum, opium, emetics, leeches around the anus. 

Asthma. — Treatment : — Blood - letting, hyosciamus, 
stramonium, emetics of ipecac, squills, vinegar, digitalis, 
opium, skunk cabbage, lobelia inflata, galvanism, tonics, 
bark, quinine, arsenic, carbonate of iron, blue-pill, tepid 
shower bath, warm bath. 

Asphyxia from drowning. — Treatment : — Artificial 
inflation of the lungs, gradual warmth, friction with a .dry 
flannel, mustard and capsicum, stimulating injections, 
warm wine, weak brandy toddy, infusions of balm, sage 
or catnip. 

Asphyxia, from mephitic gases.-— Treatment : — Dash- 
ing cold water on the face and breast, dry frictions to the 
extremities, cold wine, cold shower bath at short intervals, 
flesh brush, ammonia, stimulating injections, artificial 
respiration, abstraction of blood, warm wine, galvanism. 

Asphyxia from Electricity. — Treatment : — Cold water 
copiously dashed over the whole body, frictions with the 
flesh-brush. 

Asphyxia from cold. — Treatment: — Gradual communi- 
cation of warmth to the body, immersion in spring water 
continued forty minutes, gentle frictions with flannel, arti- 
ficial respiration, gentle stimulants, such as balm, sage, 
warm wine, &c. 

PneumoxAhorax. — Treatment : — Blistering, tartar- 
emetic ointment, cupping, moxa, issues, setons, &c. 

Dilatation of the ventricles. — Treatment: — Bleeding, 
low diet, starvation and venesection, diuretics, squills, 
nitre, digitalis, purgatives, antimony, valerian, orange 



ALLOPATHIC PRACTICE. 335 

flowers, catmint, mercury, castor oil, bine-pill, tepid 
shower bath. 

Sympathetic affection of the heart. — Treatment: — 
Gentle aperients, tepid bath, gentle tonics, bitters, iron, 
bleeding, warm pediluvium, digitalis. 

Angina- Pectoris. — Treatment: — Bleeding, ether, cam- 
phor, opium, hyoscyaruus, ammonia, draughts of cold 
water, emetics, leeches, sinapisms to the legs, mild diet, 
blue-pill, tepid or cold bathing. 

Indigestion. — Treatment : — Diet, gentle aperients, mild 
tonics, regular exercise, rhubarb, aloes, soda, ipecac, 
hyoscyamus, boneset, mild tonics, alkalies, calomel, gen- 
tian, iron, white mustard seed, mercury, antimony, nitro- 
muriatic acid bath, opium, ammonia, nitrate of potash, 
leeches, blisters. 

Diarrhoea. — Treatment : — Mild purgatives, calomel, 
castor oil, ipecac, laudanum, chalk, warm bath, leeching, 
Dover's powder, acetate of lead, balsam copaiva, sul- 
phate of copper, injections of mallows, flaxseed or barley 
water, sulphuric acid. 

Cholera. — Treatment: — Opium, sinapisms to the region 
of the stomach and liver, free use of bland drinks, fric- 
tions with spirits of turpentine, calomel, warm bath, 
tinct. of" capsicum to the extremities, camphor in vitriolic 
ether, mucilages in a warm state, ipecac, columbo, calomel, 
ammonia. 

Cholera Infantum. — Treatment : — Leeches to the 
temple, calomel, poultices over the abdomen, blisters 
behind the ears, ipecac, mild laxatives, castor oil, warm 
bath, spirits-, Dover's powder, magnesia, tartrate of iron, 
charcoal, wine whey, milk punch, ammonia, common soot. 

Flatulent colic. — Treatment: — Rapid friction with the 
flesh-brush, camphor, laudanum, vitriolic ether, oil of 
juniper, emetics of ipecac, essence of peppermint, ca- 



336 ALLOPATHIC PRACTICE. 

thartics, enemata, castor oil, turpentine, laudanum, bleed- 
ing, leeches, blisters. 

Bilious Colic. — Treatment: — Emetics, eupatorium, or 
camomile tea, antimony, calomel, sinapisms, or epispastics 
to the epigastrium, castor oil, enemata of castor oil and 
turpentine, opium, salivation, blood-letting, calomel, mag- 
nesia, warm bath. 

Golica Pictonum. — Treatment: — Blood-letting, opium, 
calomel, salivation, purgatives, castor oil with spirits of 
turpentine, purgatives, enemata, gl auber salts, flaxseed tea, 
blisters, leeches, tartar-emetic ointment, warm bath, senna, 
alum. 

Ileus. — Treatment: — Bleeding, cupping, leeches, opium, 
purgatives, calomel, castor oil, enemata of warm water, 
tobacco, cold water, &c, cold effusions, mercury, tincture 
of rhubarb, and aloes. 

Constipation. — Treatment : — Proper diet, active exer- 
cise, regular attempts at stool, calomel, rhubarb, jalap, 
aloes, enemata, blue-pill, aloes and antimony, castor oil, 
oil of turpentine, salivation. 

Intestinal Worms. — Treatment : — Spare and liquid 
diet, mild purgatives, epsom salts, spigelia, followed by 
calomel and jalap, tin filings, spirits of turpentine, male 
fern, pomegranate root. 

Hemorrhoids, Piles. — Treatment : — Light vegetable 
diet, bleeding, sulphur, cream of tartar, blue mass, nitre, 
cupping, sinapisms, blisters, injections of cold water, 
acetate of lead, quinine, opium, cinnamon, aloes, ipecac, 
astringents, injections, excision of tumors, balsam copaiva, 
oil of turpentine, aloetic purgatives. 

Jaundice. — Treatment : — Opium, warm bath, leeching, 
frictions, emollient applications to the epigastrium, bleed- 
ing, purgatives, enemata, emetics, ipecac, mercury, mer- 
curial frictions, nitro-muriatic acid bath, proper diet. 

Diabetes Mellitus. — Treatment: — Bleeding, leeching, 



ALLOPATHIC PRACTICE. 33T 

cupping, opium, lime water, alum, uva ursi, active exer- 
cise, friction with flannel, carbonate of ammonia, blisters, 
quinine, exclusive animal diet. 

Diabetes Insipidus. — Treatment : — Tonics, alkalies, 
opium, quinine, bitartrate of soda, mercury, ipecac, mag- 
nesia and rhubarb, lime water, uva ursi, hyoscyamus, cam- 
phor, gum arabic, mineral acids, quinine, iron, burgundy 
pitch, galbanum and turpentine to the loins, castor oil. 

Lithic acid diathesis. — Treatment : — Proper diet, mild 
aperients, alkalies, bitters, vegetable tonics, calomel, anti- 
mony, magnesia, soda, salorratus, gentian, columbo, warm 
bath, opium, hyoscyamus, vegetable diuretics, bleeding, 
cupping, colchicum. 

Phosphatic diathesis'. — Treatment : — Opium, tonics, 
mineral acids, cinchona, uva ursi, pitch, soap or galbanum 
plaster to the kidneys, issues in the back, hyoscyamus, 
country air, exercise. 

Ischuria renalis. — Treatment : — Bleeding, cupping, 
leeching, warm bath, blisters, stimulating diuretics, spirits 
turpentine, castor oil, balsam copaiva, juuiper oil, nitre 
and laudanum, mercury. 

Retention of urine. — Treatment : — Introduction of 
catheter, canth, camphor, blisters to the pubic region, 
spirits of turpentine, juniper, oil, dipple oil, Peruvian bal- 
sam, cold water to the pubic region, blood-letting, leeching, 
emollient clysters, fomentations, mild purgatives, anti- 
mony, warm bath, calomel, opium. 

Dysuria, pain in voiding urine. — Treatment : — Mild 
laxatives, flaxseed tea, gum arabic, Dover's powder, castor 
oil, rhubarb, calomel, ipecac, lunar caustic, borax, citron 
ointment, zinc or alum injected into the vagina, diluents, 
opiates, fomentations, anodyne enemata, flaxseed tea. 

Enuresis, incontinence of urine, — Treatment : — Alum, 
cantharides, uva ursi, iron, cold shower bath, electricity, 
stimulating frictions, cupping the perineum, blisters, ano- 
29 



338 ALLOPATHIC PRACTICE. 

dyne enernata, Dover's powder, stramonium, tonics, iron, 
quinine, oxyde of zinc, spirits of turpentine. 

Ascites. — Treatment : — Blood-letting, cups, leeches, 
blisters, setons, drastic purgatives, cream of tartar, ele- 
terium gamboge, diuretics, squills, digitalis, acetate of 
potash, nitrate of potash, cantharides, juniper berries, col- 
ohicum, spirits of turpentine, erigeron, heteraphullum and 
parsley, calomel. 

Scrofula. — Treatment : — Diet and regimen, pure air, 
calomel, blue mass aperients, rhubarb, tonic vegetable 
bitters, gentian, quinine, leechos, saturnine solutions, nitrate 
of silver, sulphate of copper, corrosive sublimate, sarsa- 
parilla, conium, antimony, setons. 

Bronchocele, Goitre. — Treatment : — Iodine, burnt 
sponge, calcined egg shells, sea water, squills, kermes 
minerals, belladonna, conium, digitalis, mercury, antimony, 
blistering, cataplasms, mercurial ointment. 

Scorbutus, Scurvy. — • Treatment : — Fresh vegetables 
and animal food, lemon juice and vinegar, nitre, iron tonics, 
cinchona, muriate of lime, lunar caustic. 

Chlorosis.' — Treatment: — Exercise, purgatives, aloes, 
rhubarb, calomel, ipecac, hyoscyamus, Dover's powders, 
diet, sea-bathing, tepid shower bath, tonics, iron. 

Gonorrhoea, Clap. — Treatment : — Blood-letting, saline 
purgatives, nitre, antimony, gum arabic, warm fomenta- 
tions, opium, camphor, balsam copaiva, cubebs, spirits of 
turpentine, injections of sulphate of zinc, and sulphate of 
copper, nitrate of silver, lunar caustic, cantharides, sarsa- 
parilla, mercury. 

Syphilis. — Treatment : — Mercury, emollient poultices, 
lead, sulphate of copper, citron ointment, corrosive subli- 
mate, lunar caustic, bleeding, antimony, zinc, nitre, quinine, 
opium, hyoscyamus, cicuta, nitrate of silver, Venice tur- 
pentine, balsam of copaiva, myrrh, red precipitate oint- 
ment, salivation, warm bath, guaiacum. 



HOMOEOPATHIC PRACTICE. 339 

Buboes. — Treatment : — Mercury, frictions, emollient 
poultices, hydriodate ointment, bleeding, purgatives, anti- 
mony, lead water, blisters, opium, sarsaparilla, lead, copper, 
corrosive sublimate, galbanum, cicuta, carrot poultices, 
nitric acid, hyoscyamus. 

Amenorrhea. — Treatment : — Blood-letting, opium, 
ether, active cathartics, purgatives, enemata, sinapisms, 
warm pediluvium, camphor, ergot, blisters, warm bath, 
antimonials, iron, ipecac, castor oil, balsam copaiva, 
spirits of turpentine, cantharides. 

JDysmenorrhcea. — Treatment : — Camphor, Dover's 
powder, elder blossoms, or eupatorium tea, opium, ipecac, 
warm bathing, bleeding, aperients, blue-pill, ipecac emetics, 
antimony, guiacum, sulphur, stramonium. 

Leucorrhcea, fluor albus. — Treatment: — ^Bleeding, 
purgatives, antimony, blue-pill, injections of warm water 
and sugar of lead into the vagina, cantharides, balsam 
copaiva, turpentine, alum, ipecac, astringent injections, 
such as zinc, copper, alum, oak bark, sulphuric acid, and 
nitrate of silver. 

Cholera Asphyxia. — Treatment : — Calomel, opium, 
camphor, sulphuric ether, mild purgatives, rhubarb, or 
castor oil, sinapisms, alcoholic vapor bath, blood-letting, 
cupping, leeches, frictions with tincture of capsicum, brandy, 
ammonia, turpentine, sugar of lead, mustard, emetics. 

HOMOEOPATHIC PRACTICE. 

The following are Hahnemann's remarks on the tritu- 
rating process of Homoeopathic remedies, as transcribed 
from Jahr's and Gruner's Pharmacopeia. 

"All those homoeopathic drugs which constitute the 
pure materia medica, are prepared in the manner pointed 
out below. The following anti-psorics come under this 
remark : silica, calcarea carbonica, natrum carbonicum, 
ammonium carbonicum, magnesia carbonicum, baryta carbo- 



340 HOMOEOPATHIC PRACTICE. 

nica, carbo-vegetabilis, carbo-animalis, graphites, sulphur, 
antimonium erudum, antimonium, gold, platinum, zinc, 
copper, silver, tin. Lumps of these metals, not the foil, 
are rubbed upon a hard, fine hone, under water, or some- 
times under alcohol ; for example, iron. Of these pulve- 
rized substances you take one grain, mercury may be used 
in the liquid state ; of petroleum you take one drop instead 
of one grain. Put this grain into an unglazed porcelain 
mortar, then you take thirty -three grains of sugar of milk, 
and mix them with the drug, by triturating the mass with 
some force for about six minutes, by means of a porcelain 
pestle ; before you triturate, stir the mass for a little while 
with a spatula. Having triturated the mass, you stir it 
again for about four minutes, scraping up that part which 
covers the bottom of the porcelain mortar, and also that 
which adheres to the pestle ; then you triturate again with 
great force for about six minutes, without, however, adding 
anything new. This mass you scrape up again for about 
four minutes ; then add another thirty-three grains of 
sugar of milk, stir the new compound for a minute with a 
spatula, then triturate it for six minutes with the pestle, 
scrape it up for four minutes, triturate again with great 
force for six minutes, scrape up the mass again four min- 
utes, then add the last thirty-three grains of sugar of milk, 
and with this last added portion proceed as with the two 
former. This powder you enclose in a well-corked glass 
vial, and mark it with the name of the substance, and the 
figure t -Jq, to show that this is the first potency of the 
substance. In order to prepare the degree T o-Joo> ^ ou 
take one grain of the degree T -J ^, and add to it thirty- 
three grains of the sugar of milk. Stir up this mass for 
a moment with the spatula. Then triturate for six min- 
utes, stir it up for four minutes, triturate again for six 
minutes, and then stir up again for four. After this, you 



HOMEOPATHIC PRACTICE. 341 

add the second thirty-three grains of sugar of milk, pro- 
ceed then as before ; afterwards add the last thirty-three 
grains of sugar of milk, stir up and triturate again as 
before, and enclose the mass in a well-corked vial, marked 
T<raoo> or second potency. 

" To prepare the degree T ooijooo> or tnirc l potency, you 
take one grain of the degree T o wo> an d &° through the 
processes of stirring and triturating in the same way as 
before, employing upwards of an hour for the preparation 
of each different potency. For the sake of establishing a 
sort of uniformity in preparing homoeopathic remedies, 
and especially the anti-psorics, I never carry the tritura- 
tion above the millionth degree. From this degree, I 
derive the dilutions in their various degrees of potency. 
For the process of trituration, a certain force should be 
employed ; not too much, however, lest the mass adhere 
too tenaciously to the mortar, to be scraped up in four 
minutes. 

"Froin the millionth degree of trituration, the dilutions 
in the various degrees may be obtained by dissolving these 
triturated substances in alcohol or water. Chemistry is 
not acquainted with the fact that, all substances, after 
having been triturated up to the millionth degree, can be 
dissolved in either alcohol or water. Sugar of milk cannot 
be dissolved in pure alcohol ; this is the reason why the 
first dilution should be composed of one-half water, and 
one-half alcohol. To one grain of the millionth, you add 
fifty drops of distilled water, and turn the vial several 
times around its axis ; by this means the sugar of milk 
becomes dissolved : then, you add fifty drops of good 
alcohol, and shake the vial twice, first carrying the arm 
up and then down. Only two-thirds of the vial should be 
filled with the solution. 

" This vial is then marked with the name of the medicine, 
29* 



342 HOMOEOPATHIC PRACTICE, 

and the number T -J- . Of this solution you take one drop, 
and mix it with ninety-nine or one-hundred drops of pure 
alcohol, shaking the vial twice after it has been corked ; 
this vial is marked T q^oo- Of this solution you take one 
drop, and mix with it ninety-nine or one-hundred drops 
of pure alcohol, then shake the vial twice, and mark it 
tooIjooo* 0^ ^ s potency you again take a drop, and 
mix it with ninety-nine or one-hundred drops of alcohol, 
shaking this third vial twice, and mark it TT . In the same 
way you continue the prepartion, and marking of the 
higher potencies, TJ5J5 TT , TUTJTnj TT , TTT , m ? , &c 

11 The intermediate vials are put in perpendicular boxes 
and kept in the dark, in order not to be affected by the 
light of day. In practice only the full vials are used. 
The shaking being accomplished by means of moderate 
strokes with the arm, it is desirable that the vials be of 
such size that the one-hundred drops will only two-thirds 
fill them. Vials that have contained one medicine, ought 
never to be used for another even if they have been pre- 
viously rinsed with great care." 

" Vegetable substances which can only be had dry, are 
triturated in the same manner. The millionth trituration 
may then be dissolved, like all the other substances, either 
in water or alcohol. In this state, they may be preserved 
much better and longer than the common tinctures which 
easily spoil. 

" Of the juiceless vegetable substances, oleander, thuja, 
mezereum, you may take one grain and a half, the fresh 
leaves, bark, roots, &c , and convert them into the mil- 
lionth trituration, with three times one-hundred grains of 
sugar of milk. Of this trituration you take one grain, 
and carry it through the vials, obtaining in this way any 
degree of potency that may be desired ; shake each vial 
twi^e, first carrying the arm up and then down. The 



HOMEOPATHIC PRACTICE. 343 

same process of trituration may be resorted to in regard 
to the recently obtained medicinal juices. Squeeze the 
juice out of the substance, triturate one drop with the 
necessary quantity of sugar of milk to obtain the millionth 
trituration. Of these you take one grain, dissolve it in an 
equal proportion of water and alcohol, and then carry a 
drop of this mixture through a series of twenty-seven 
vials, obtaining in this way the degree of potency that is 
desired. 

" By triturating the juice first, the medicinal virtues of 
the drug are better developed, than by simply mixing the 
juice with the alcohol by means of two shakes. I know 
this from experience. 

"In the beginning of my practice, I gave a small portion 
of a grain of the millionth trituration at a dose. But the 
uncertainty of this mode of exhibiting the remedy, led me 
to the discovery of preparing the dilutions, and to the use 
of the globules, any definite number of which may be 
moistened with the dissolved drug. Homoeopathy being 
based upon a law of nature, it should avoid and exclude 
all uncertainties. 

"Frequent observations have convinced me that it is 
better to shake the vial twice only, in order to develop the 
medicinal virtue of the drug just enough to affect the 
disease in a proper manner. By shaking the vial ten 
times, as I was in the habit of doing, the proportion be- 
tween the progressively developed intensity of action of 
the medicinal properties of the drug, and the degree of 
potency, were destroyed. The object of the dynamizing 
process, is to develop the intensity of action of the medi- 
cinal properties of the drug, at the same time as that 
action is reduced to a milder tone. Two shakes are suffi- 
cient to establish the due proportion between these two 
effects. 



344 HOMOEOPATHIC PRACTICE. 



Table showing the quantity of alcohol or fluid, required to dissolve 
one single grain or drop of a homoeopathic drug (as sulphur^ 
aconite, etc.), down into the following homoeopathic attenuations 
or dilutions. — [Dr. Simpson on Homoeopathy, p. 285.] 

1st attenuation. — One grain or drop in one and half tea- 
spoonful of alcohol. 

2d attenuation. — One grain in twenty-one fluid ounces 
of alcohol. 

3d attenuation. — One grain in two thousand and eighty 
ounces, or in one hundred and four pints of alcohol. 

6th attenuation. — One grain in thirteen million gallons, 
or in two hundred and six thousand hogsheads, or 
in fifty-one thousand tuns of alcohol. 

9th attenuation. — One grain in a lake of alcohol with a 
volume of about fourteen cubic miles, or in a lake of 
fifty fathoms in depth, and presenting two hundred 
and fifty square miles of surface. 

12th attenuation. — One grain in a sea containing about 
fourteen million cubic miles of alcohol, or in a quan- 
tity of fluid equal to a sea six times the size of the 
Mediterranean Sea. 

15th attenuation. — One grain in an ocean of fourteen bil- 
lion cubic miles of alcohol, or in an ocean about 
forty-six thousand times greater than the whole waters 
of all the oceans of the earth. 

24th attenuation. — One grain in an ocean of fourteen 
quintillion cubic miles of alcohol, or in a quantity 
sufficient to make one hundred and forty masses, each 
filling a sphere extending from limit to limit of the 
orbit of the planet Neptune. 



HOMOEOPATHIC PRACTICE, 345 

30tli attenuation. — One grain in an ocean of fourteen sep- 
tillion cubic miles of alcohol, or in a quantity suffi- 
cient to make one hundred and forty billion spherical 
masses, extending from limit to limit of Neptune's 
orbit, or in a quantity equal to many hundred spheres, 
each with a semidiameter or radius extending from 
the earth to the nearest fixed star. 

List of diseases and Homoeopathic remedies by Dr. J. Laurie. 

The remedies of the vegetable kingdom are the third attenua- 
tion, those of the mineral kingdom of the fourth. 

Typhus fever. — Remedies : — Bryonia, arsenic, rhus 
toxico, croton oil, nux vomica, aconite, belladonna, cam- 
phor, hen-bane, cocculus Indicus, arnica. The sugar 
globules are moistened with these tinctures, and five or 
six given every two or three hours: 

Intermittent fevers. — Remedies : — Quinine, arsenic, 
ipecac, nux vomica, antimony, belladonna, opium, coc- 
culus Indicus, Ignatia or St. Ignatius' bean, white helle- 
bore, aconite, Cayenne pepper. 

Bilious fever. — Remedies: — Aconite, belladonna, bry- 
onia, chamomilla, nux vomica, mercurius, Pulsatilla, qui- 
nine, digitalis, ipecac, tartar-emetic, arsenic. 

Yellow fever. — Remedies : — Belladonna, bryonia, rhus 
toxicodendron, arsenic, nux vomica, veratrum album, la- 
chesis, or viper poison, Spanish flies, mercurius. 

Scarlet fever. — Remedies: — Belladonna, mercurius, 
arsenic, nux vomica, pulsatilla, aconite, opium, tartar- 
emetic. 

Scarlet Rash. — Remedies : — Belladonna, aconite, coffea, 
sulphur, ipecac, pulsatilla, bryonia, dulcamara, belladonna, 
arsenic, phosphorus, rhus tox, swamp sumach, cinchona, 
conium, mercurius, capsicum. 

Rubeola, measles. — Remedies: — Aconite, coffea, pulsa- 
tilla, sulphur, nux vomica, bryonia, ipecac. 



346 HO MYOPATHIC PRACTICE. 

Variola, small-pox. — Remedies : — Coffea, chamomilla, 
aconite, ipecac, tartar-emetic, bryonia, rhus, belladonna, 
Pulsatilla, stramonium, muriatic acid, mercurius, sulphur, 
lachesis, vegetable charcoal, arsenic, cinchona, phosphorus, 
sulphuret of lime, acetate of copper. 

Varicella, chicken-pox. — Remedies : — Aconite, coffea, 
belladonna, emetic tartar, mercurius. 

Miliary fever. — Remedies : — Aconite, coffea, bella- 
donna, veratrum, arsenic, ipecac, bryonia, nux vomica, 
carbonate of lime, chamomilla, tincture of sulphur, acetate 
of copper. 

Urticaria, nettle-rash. — Remedies: — Dulcamara, aco- 
nite, nux vomica, pulsatilla, crude antimony, belladonna, 
sulphuret of lime, rhus, bryonia, nettles, sulphur, nitric 
acid, lime. 

Quinsy.— Remedies : — Mercurius, lachesis, pulsatilla, 
cantharides, nux vomica, chamomilla, coffea, ignatia, sul- 
phur, veratrum, capsicum. 

Mumps. — Remedies: — Mercurius, belladonna, coccu- 
lus, carbo-vegetabilis. 

Indigestion. — Remedies: — Pulsatilla, arsenic, chamo- 
milla, rhus toxicodendron, sulphur, ipecac, cinchona, nux 
vomica. 

Flatulent Colic. — Remedies: — Cinchona, arsenic, nux 
vomica, pulsatilla, carbo-vegetabilis, colchicum, belladonna. 

Hcematemesis, vomiting blood. — Remedies : — Nux vo- 
mica, pulsatilla, cinchona, arnica, sulphur. 

Constipation. — Remedies : — Opium, bryonia, lachesis, 
alum, nux vomica, lead, platina, nitro-muriatic acid, silicea, 
lycopodium, china. 

Hemorrhoids. — Remedies : — Aconite, nux vomica, 
sulphur, arsenic, belladonna, rhus, pulsatilla, platina, 
ignatia, colocynth. 

Prolapsus ani. — Remedies : — Ignatia, nux vomica, 
mercurius, sulphur, calcarea. 






HOMCEOPATHIC PRACTICE. 347 

Diarrhoea. — Remedies : — Dulcamara, bryonia, cinchona, 
cbamomilla, mercurius, rhubarb, pulsatilla, ipecac, nux 
vomica, colocynth, arsenic, crude antimony, rhus, lachesis, 
nitric acid, phosphoric acid, magnesia. 

Dysentery. — Remedies : — Aconite, chamomilla, ipecac, 
mercurius, corrosive sublimate, bryonia, arsenic, carbo- 
vegetabilis, cinchona, cantharides, sulphur. 

Cholera. — Remedies : — Ipecac, veratrum album, arsenic, 
cinchona, pulsatilla, copper, sulphur, carbo vegetabilis, 
nux vomica, ergot, stramonium. 

Cholerine. — Remedies : — Yeratrum, mercurius, pul- 
satilla, nux vomica, chamomilla, colocynth, ferruin, Dul- 
camara, carbo vegetabilis, cantharides. 

Inflammation of the liver. — Remedies : — Belladonna, 
aconite, nux vomica, chamomilla, mercurius, arsenic, Pul- 
satilla, nux vomica. 

Jaundice. — Remedies : — Mercurius, cinchona, pulsa- 
tilla, digitalis, chamomilla. 

Inflammation of the spleen. — Remedies: — Aconite, 
arsenic, cinchona, nux vomica, bryonia. 

Inflammation of the stomach. — Remedies : — Aconite, 
belladonna, ipecac, crude antimony, nux vomica, lachesis, 
Pulsatilla, arsenic, cantharides, hyoscyamus, arnica. 

Inflammation of the bowels. — Remedies : — Arsenic, 
mercurius, nux vomica, lachesis, nitric acid, bryonia, pul- 
satilla, colocynth, chamomilla, cinchona, colchicum, phos- 
phorus, sulphur, silicea. 

Inflammation of the peritoneum. — Remedies : — Aco- 
nite, belladonna, arsenic, chamomilla, lycopodium, colo- 
cynth. 

Worms. — Remedies: — Aconite, ferrum, nux vomica, 
mercurius, sulphur, calcarea, silicea, pulsatilla, ipecac, 
antimony, cicuta, cinchona. 

Laryngitis. — Remedies : — Sulphur, burnt sponge, 
Aconite, lachesis, belladonna, hyoscyamus. 



348 HOMOEOPATHIC PRACTICE. 

Hooping Cough. — Remedies : — Dulcamara, Pulsatilla, 
mercurius, belladonna, aconite, ipecac, nux vomica, cha- 
momilla and sulphur. 

Group. — Remedies : — Aconite, sulphur, burnt sponge, 
arsenic, tartar emetic, lachesis, caustic, ammonia, bromin. 

Influenza. — Remedies : — Camphor, aconite, mercurius, 
arsenic, bryonia, phosphorus, belladonna, pulsatilla, arnica. 

Bronchitis. — Remedies : — Aconite, pulsatilla, bryonia, 
sponge, belladonna, nux vomica, lachesis, mercury, lyco- 
podium, stannum, dulcamara, arsenic, ipecac, tartar-emetic. 

Pneumonia. — Remedies : — Aconite, bryonia, phos- 
phorus, tartar - emetic, mercurius, belladonna, lachesis, 
arsenic, antimony, sulphur. 

Pleuritis. — Remedies : — Aconite, bryonia, sulphur, 
mercurius, arsenic, arnica. 

Hcemoptysis. — Remedies : — Pulsatilla, bryonia, nux 
vomica, rhus, arnica, aconite, ipecac, iron, opium, cin- 
chona. 

Consumption. — Remedies : — Ipecac, arsenic, nux 
vomica, bryonia, pulsatilla, tartar-emetic, opium, china, 
sambucus, musk, belladonna, lachesis, veratrum, dulcamara, 
cinchona, stannum. 

Determination of the blood to the head. — Remedies : — 
Aconite, nux vomica, calcarea, belladonna, opium, coffea, 
chamomilla, ignatia, arnica, mercurius, pulsatilla, lycopo- 
dium, dulcamara, sanguinaria, cinchona, sulphur, carbo- 
nate of lime, opium, conium. 

Inftamxmation of the brain and its membranes. — Reme- 
dies :— Aconite, belladonna, bryonia, hyoscyamus, opium, 
stramonium, zinc, acetate of copper, rhus, lachesis, mer- 
curius. 

Apoplexy. — Remedies : — Aconite, belladonna, nux 
vomica, opium, lachesis, arnica, pulsatilla, ipecac, carbo- 
nate of barytes. 

Paralysis, Palsy. — Remedies : — Arnica, bryonia, rhus, 
Bulphur, electricity, galvanism. 



HOMOEOPATHIC PRACTICE. 349 

Tetanus. — Remedies : — Belladonna, cicuta, opium, 
arnica, ignatia, stramonium, hyoscyamus. 

Delirium Tremens. — Remedies : — JSux vomica, opium, 
aconite, belladonna, lachesis, sulphur, calcarea. 

Epilepsy. — Remedies: — Belladonna, copper, hyoscya- 
mus, ignatia, lachesis, nux vomica. 

Neuralgia. — Remedies : — Belladonna, platina, lyco- 
podium, arsenic, colocynth, veratrum, china, assafcetida, 
spigelia. 

Headache. — Remedies: — Belladonna, bryonia, rhus, 
sepia, silicea, pulsatilla. china, veratrum, lachesis, mer- 
curius, colocynth, chamomilla, sulphur. 

Erysipelas. — Remedies : — Aconite, belladonna, bryonia, 
Pulsatilla, rhus, arsenic, lachesis, sulphur, copper. 

Carbuncle. — Remedies: — Lachesis, silicea, arsenic. 

Chilblains. — Remedies : — Nux vomica, pulsatilla, bel- 
ladonna, rhus, nettles, arsenic, sulphur. 

Corns. — Remedies: — Arnica, ammonia, bryonia, nux 
vomica, rhus, ignatia. 

Scabies, Itch. — Remedies : — Sulphur, mercurius, vera- 
trum, silicea, sulphuric acid, arsenic, dulcamara, pulsa- 
tilla. 

Herpes Circinatus, Ringworm. — Remedies : — Rhus, 
sulphur, calcarea. 

Scald - head. — Remedies : — Rhus, sulphur, arsenic, 
dulcamara, bryonia. 

Inflammation of the kidneys. — Remedies : — Aconite, 
cantharides, arsenic, sulphur, mercurius, arnica, nux 
vomica. 

Cystitis, inflammation of the bladder. — Remedies : — 
Cantharides, pulsatilla, digitalis, arsenic, carbo-vegetabilis, 
sulphur, nux vomica. 

Gravel. — Remedies : — Sarsaparilla, nux vomica, gra- 
phites, sulphur, cannabis, lycopodium, calcarea. 
30 



350 HOMEOPATHIC PRACTICE. 

Retention of the urine. — Remedies : — Aconite, cam- 
phor, arsenic, phosphorus, belladonna, cantharides. 

Difficulty in discharging urine. — Remedies : — Aconite, 
sulphur, belladonna, cantharides, opium, pulsatilla, spirits 
of camphor, mercurius, nux vomica. 

Suppression of urine. — Remedies : — Aconite, cantha- 
rides, pulsatilla, camphor, belladonna, opium, lycopodium, 

Diabetes. — Remedies : — Veratrum, mercurius, nitric 
acid. 

Hcematuria. — Remedies : — Cantharides, quinine, pulsa- 
tilla, mercurius, sulphur, ipecac, camphor, carbo-vegeta- 
bilis, arnica, nux vomica, nitric acid, aconite, squills, zinc, 
calcarea, petroleum, cannabis, cocculus indicus, capsicum. 

Gout. — Remedies: — Aconite, pulsatilla, arsenic, iron, 
nux vomica, bryonia, sanguinaria, sulphur, saffron. 

Rheumatism. — Remedies : — Aconite, bryonia, sulphur, 
belladonna, rhus, chamomilla, ignatia, conium, mercurius, 
lachesis, pulsatilla, arnica, mezereum, euphorbium, pink 
root, digitalis, phosphorus, veratrum, caustic. 

Lumbago. — Remedies : — Aconite, bryonia, nux vomica, 
rhus, belladonna, pulsatilla, mercurius. 

Ophthalmia. — Remedies: — Aconite, belladonna, nux 
vomica, cinchona, arsenic, euphrasia, ignatia, pulsatilla, 
mercurius, sulphur. 

Scrofulous Ophthalmia. — Remedies : — Arsenic, conium, 
crude sulphur, lime, bitter sweet, iron, graphites, gold, 
lycopodium, indian hemp, chamomilla, digitalis, iodine, 
mercurius, corrosive sublimate, magnesia, nitric acid, 
lachesis, cinchona, pink root. 

Ulceration of the cornea. — Remedies : — Nitric acid, 
arsenic, euphrasia, sulphur, calcarea, mercurius, lachesis, 
silicea, nitre. 

Epistaxis. — Remedies : — Aconite, belladonna, bryonia, 
mercurius, carbo vegetabilis, graphites, pulsatilla, calcarea, 



HOMOEOPATHIC PRACTICE. 351 

arnica, rhus, iron, sepia, nux vomica, lachesis, bryonia, 
dulcamara, saffron, musk, ammonia, silicea. 

Stomacace. — Remedies : — Mercurius, nitric acid, nux 
vomica, capsicum, carbo-vegetabilis, sulphur, nitre, borax, 
iodine, lemon juice, dulcamara. 

Scurvy. — Remedies: — Vegetable carbon, mercurius, 
nux vomica, Pulsatilla, sulphur, creosote, belladonna, 
nitric acid, quinine, alum, arnica, chamomilla. 

Ascites. — Remedies : — Arsenic, cinchona, iron. 

Anasarca.— Remedies : — Hellebore, bryonia, mercurius, 
arsenic, phosphorus, iron, colchicum. 

Hydrothorax, dropsy of the chest. — Remedies : — Ar- 
senic, dulcamara, digitalis, pink root, bryonia, aconite. 

Hydrophobia. — Remedies : — Belladonna, hyoscyamus, 
stramonium, cantharides. 

Amenorrhea. — Remedies: — Xux vomica, sulphur, 
opium, aconite, veratrum, pulsatilla. 

Menorrhagia. — Remedies : — Nux vomica, chamomilla, 
sabina, ignatia, platina, veratrum, sulphur. 

Dysmenorrhoea. — Remedies : — Pulsatilla, belladonna, 
nux vomica, coffea, sulphur, calcarea, chamomilla. 

Turn of life. — Remedies : — Cocculus, aconite, pulsatilla, 
nux vomica, lachesis. 

Leucorrhcea. — Remedies : — Pulsatilla, china, calcarea. 

Hysteria. — Remedies : — Calcarea, nitric acid, veratrum, 
belladonna, pulsatilla, gold, stramonium. 

Difficult dentition. — Remedies : — Chamomilla, bryonia, 
zinc, sulphur. 

Sugar globules are medicated with these remedies, in 
the third to the sixth potencies. 



552 



HOMEOPATHIC PRACTICE. 



Method of preparing the sugar globules, from Jahr and Gruner, 
p. 27. 

These are made by confectioners, and are composed of 
sugar and starch ; they can be had of different sizes, from 
that of a millet-seed to that of a buck-shot. The whitest, 
dryest, and hardest, should be selected for medicinal use ; 
they should be all of equal size, and not mixed with sugar- 
dust. After having moistened the globules with the medi- 
cine in some suitable vial, we turn them out on paper with 
raised edges, and agitate them until they cease to adhere 
one to the other. Should we afterwards wish to put them 
into the same bottle in which we had moistened them, we 
should take care to dry it also, before making use of it. 
The complete desiccation of the globules, before bottling 
them, is absolutely indispensable, since, without that pre- 
caution, they fall into powder in a short time, and lose 
their medicinal virtues. 

A table showing the amount of alcohol required to form the dif- 
ferent dilutions. One grain of the millionth degree of tritura- 
tion, is added to 100 drops of alcohol, and one drop of that to 
100 more of alcohol, making the first dilution. 



First 


attenuation 


= 


1 


= 


100 = hundredths 


Second 


a 


— 


2 


= 


10,000 = ten thousandths. 


Third 


n 


z= 


3 


= 


I = millionths. 


Fourth 


" 


— 


4 


= 


100 I = hundred millionths. 


Fifth 


a 


z=z 


5 


zz 


10,000 I = ten thousand millionths 


Sixth 


a 


zz 


6 


3= 


II — billionths. 


Seventh 


<t 


zz 


7 


— 


100 II zz hundred billionths. 


Eighth 


it 


zz 


8 


= 


10,000 II = ten thousand billionths. 


Ninth 


a 


= 


9 


= 


Ill zz trillionths. 


Tenth 


a 


zz 


10 


— 


100 III zs hundred trillionths. 


Eleventh 


a 


— 


11 


~ 


10,000 III = ten thousand trillionths. 


Twelfth 


a 


fc= 


12 


— 


IV =: quadrillionths. 


Fifteenth 


a 


= 


15 


— 


V zz quintillionths. 


Eighteenth 


a 


— 


18 


— 


VI =: sextillionths. 


Twenty-first 


'" 


fc 


21 


~ 


VII zz septilliontlfs. 


Twenty-fourth 


it 


= 


24 


— 


VIII zz octillionths. 


Twenty-seventh 


a 


= 


27 


~ 


IX ~ nonillionths. 


Thirtieth 


a 


— 


30 


zz 


X =: decillionths. 



HYDROPATHIC PRACTICE. 353 



HYDROPATHY. 

By Hydropathy is understood a system of medical prac- 
tice, in which water, in its various applications, consti- 
tutes the only remedy. R. T. Trail, M; D., in his work 
on the hydropathic system of practice, states, that in order 
to understand the philosophy of water-cure, it is necessary 
to understand the physiological relations of water to the 
healthy organism. These he states in the following pro- 
positions : 

"1. Water constitutes the greater proportion of the 
entire bulk of the body. 

" 2. Water composes more than three-fourths of the 
whole mass of blood, more than seven-eighths of the sub- 
stance of the brain, and more than nine-tenths of the 
various colorless fluids and secretions. 

"3. Water is the only medium through which waste, 
or effete particles of extraneous matter, are conveyed from 
all parts of the system to the excretory organs to be ex- 
pelled. 

" 4. Water is the only solvent diluent and detergent in 
existence, for animal and vegetable excrementitious matter. 

" 5. Water is- the only material capable of circulating in 
all the tissues of the body and penetrating their finest 
vessels, without vital irritation or mechanical injury. 

" 6. The only morbid effects result from improper tem- 
perature, and over-distension of the hollow viscera, or 
circulating vessels, from excess of quantity — effects never 
necessarily unavoidable." 

Hydropathists claim disease to be the result of the mis- 
use or abuse of some one or more of the hygienic agencies, 
such as bad air, impure light, defective aliment, indolence, 
&c. They still further claim, that medicinal drugs never 
tend to correct the functional disturbances produced by 
these morbid inflnences, although animal organism consists 
30* 



354 HYDROPATHIC PRACTICE. 

of true medicinal elements, and for the want of a due 
amount of which, disease is frequently produced. The 
teeth cannot be developed without lime, carbonic and phos- 
phoric acids, nor the enamel without fluoride of calcium. 
Healthy bile, mucus, sweat, saliva, tears, cartilage, &c, 
all contain carbonate of soda, and if the soda is deficient, 
these fluids are diseased. Phosphate of lime is one of 
the constituents of serum, saliva, bones and muscles, which 
may become diseased by a deficiency of this material ; by 
administering this article to the patient, he is restored. 
Hydrochloric acid is one of the ingredients of gastric 
juice, a deficiency of which, causes dyspepsia ; the most 
ample experience shows that salt will remedy the difficulty. 
Iron is oue of the ingredients of the blood, and without 
it the blood is ancemic. Iron will correct the difficulty. 
The above facts, with many others that might be adduced 
to show the utter fallacy of depending entirely upon water 
to correct the abnormal conditions of the system, yet it is 
a valuable auxiliary. The various methods of applying 
water for the cure of disease, are the following : 

1. The wet sheet pack : The mode of applying this bath, 
according to Dr. Trail, is as follows : Take a sea-grass or 
straw mattress, upon which spread from three to five large 
thick comfortables, then a soft flannel blanket, and lastly 
the wet sheet, wrung sufficiently so as not to drip. Two 
pillows placed upon the mattress are necessary for the 
head. The patient lying down on the back is quickly 
enveloped in the sheet, followed by th.e blanket and com- 
fortables. A light feather bed may be thrown over the 
top, in which case two less comfortables will be required. 
If the feet remain cold, bottles of hot water should be 
placed to them. Headache is prevented by the application 
of cold packs. In wrapping up the patient, great care 
should be taken to turn the clothing snugly and smoothly 
around the neck and feet. For very delicate persons, the 



HYDROPATHIC PRACTICE. 355 

sheet should first be wrung out of tepid or even warm 
water. On coming out of the pack, the plunge, douche, 
rubbing wet-sheet, or towel washing may be employed, as 
indicated. 

This bath is used by hydropathists in a great variety of 
diseases, both acute and chronic. In chronic disease it is 
used for the purpose of producing reaction ; hence the 
packing is continued for a considerable length of time, and 
a full amount of clothing is used. When it is used in 
acute diseases to overcome inflammation and restore the 
superficial capillary circulation, the water is used at a lower 
temperature, and the packs are more frequently changed. 
This method of applying water is a very favorite one 
among most hydropathists, in typhoid fever, inflammation 
of the bowels, lungs, &c. 

The Half Pack' Sheet. 
The half pack is the application of the wet sheet to a 
portion of the body only ; as to the bowels in Enteritis, or 
to the lungs in pneumonia. This bath is also used on 
feeble persons, and in chronic diseases where there is much 
debility. This method of applying water is a favorite one 
of mine, in all cases of inflammation of the lungs, and 
bowels, also in most chronic affections of the uterus. 

The Douche Bath, 
The douche bath may be applied either warm or cold. 
It is given by allowing a stream of cold water to fall upon 
a portion of the body from a height of four or five feet. 
The stream should be from one eighth to one half of an 
inch in diameter, and should be repeated from time to time 
as indicated. It is used in chronic affections of the liver, 
tumors, local rheumatism, inflammation of the brain, hip 
disease, &c. When the vital reaction is feeble, the water 
should be warm, but where it is vigorous, cold water should 
be used. 



356 HYDROPATHIC PRACTICE. 

Dripping Sheet. 

The dripping sheet is another form of applying cold 
water. It is given as follows : The patient standing in a 
tub, the sheet is suddenly thrown around his body, which 
it envelopes from the head to the feet, and the body is 
rubbed by the hands of the attendant, outside the sheet, 
for five or ten minutes, when the sheet should be removed, 
and the body rubbed with a dry towel. 

This bath is used in the early stage of fevers, also in 
most chronic diseases. I have found this form of bathing 
a very convenient one, not only in removing disease, but 
when used once or twice a week an excellent preventive. 

The Hip or Sitz Bath. 

For the sitting bath, sufficient water should be placed 
in a tub to cover the hips and lower portions of the abdo- 
men, when the patient is in a sitting posture. The water 
may be of any temperature to suit the indications. This 
bath is beneficial in diseases of the uterus, as leucorrhoea, 
dysmenorrhoea and prolapsus. In these diseases the baths 
are mostly used cold. 

This bath is also used in dysentery, piles, hip disease, 
&c. The baths should be repeated as often as the nature 
of the case appears to indicate. 

Shallow Bath. 

This bath is taken in a tub large enough for the patient 
to sit upright with ease. The water should be from four 
to six inches deep. The temperature of the water, as in 
other forms of bath, should be warm or cold as indicated. 
The shallow bath is used in all cases where the sitz bath is 
recommended, and in many cases to much advantage. 



HYDROPATHIC PRACTICE. 35T 

Plunge Bath. 

This process consists in immersing the whole body up to 
the neck in water quickly, where there is room sufficient 
for the patient to exercise his limbs under water. A plunge 
bath may be easily constructed where there is a running 
stream. A box eight or ten feet long, and five or six feet 
high, may serve a good purpose for this bath. This form 
of bath is of utility in all cases where there is' sufficient 
vital reaction, except in organic disease of the heart, and 
tuberculous affections of the lungs. 

Foot Bath. 

By foot bath is meant merely placing the feet in warm 
water. This is a valuable auxiliary in acute and most 
chronic diseases. It acts as a revulsive to diseases of the 
brain, stomach and bowels. Where there is determination 
of blood to the head, stomach or bowels, the bath should 
be hot, and followed by brisk friction. The benefit of the 
bath will be much increased by the addition of lye and 
pulverized mustard, in acute diseases. 

Head Baths. 

The head bath may be given in two ways. By laying 
folded towels upon the head that have been wrung out of 
cold water, or by allowing a stream of water to fall upon 
the head. The most common method in acute diseases is 
to wrap the head in wet cloths, and change as often as 
they become warm. In some violent affections of the brain, 
more benefit may be derived from a stream of cold water 
falling upon the head from some distance. 

Cataract Bath. 

This bath consists in two streams of water falling ob- 
liquely upon opposite parts of the body. This form of 



358 HYDROPATHIC PRACTICE. 

bath may be used for the same purpose as the douche, as 
also a substitute for the wave bath or plunge, when the 
patient is too weak to take the latter. 

Dry Pack, or Sweating Bath. 

This is managed as the wet-sheet packing, except for 
the wet sheet a dry blanket is substituted. In either pro- 
cess, wet cloths should be applied to the head, and plenty 
of air should be admitted into the room. This bath is 
useful where the patient has not sufficient vitality to render 
the wet-sheet pack or other cold applications practicable. 
Ague chills may be much lessened in their severity by 
this process of sweating. 

The Vapor Bath. 

This is valuable in colds the first stages of fevers, &c. 
The patient may sit on an open chair with a blanket of 
sufficient thickness to retain the steam pinned about the 
neck. A pan of water may be placed under the chair, in 
which hot bricks are immersed to keep a vapor constantly 
rising ; or a small quantity of alcohol may be burnt beneath 
the chair, to produce perspiration. This bath may be 
continued from fifteen to twenty-five minutes. 

The Wave Bath. 

This consists in extending the body in a swift current of 
water. It is for the same purpose as the plunge bath. 

The Bain Bath. 

This is taken by walking in a brisk shower, dressed in 
thin apparel. This is used for producing reaction ; it 
stimulates the glands, hence it is useful in scrofula. The 
walk should not be prolonged to produce fatigue ; when 
the patient returns, the cloths should be removed, and the 
body wiped with a dry towel. 



HYDROPATHIC PRACTICE. 359 

Portable Shower Bath. 
This process may be performed by showering the body 
with an ordinary tin shower-pot. 

The Affusion Bath. 

This consists in pouring water over different parts of the 
body, while the patient is standing in a tub. 

This is a favorite method of applying water in fevers and 
inflammatory diseases. Where this bath is used for cool- 
ing the body, it should be repeated until the object is 
accomplished. 

Towel or Sponge Bath. 

This bath consists in washing the surface with a towel 
or sponge. This is the most convenient of all the baths. 
It is used extensively in fevers. It should never be neg- 
lected in their treatment, but should be repeated two or 
three times a day. A small amount of saleratus added to 
the water is a valuable auxiliary. 

Wet Dress Bath. 

The patient is enveloped in a dripping night dress, placed 
in bed, and treated the same as in the wet sheet pack. 

Leg-Bath. 

The leg-bath consists in immersing the legs in a tub of 
water. It is used for gout, rheumatism, ulcers, diseases 
of the joints, &c. 

Fomentations. 

These are cloths wrung out of hot water, and applied 
to different parts of the body, as may be indicated. 

Wet Bandages. 

This is another method of applying cold or warm water 
to different parts of the- body. The cold, wet girdle, is 
used to good advantage in prolapsus uteri, and leucorrhoea. 



360 HYDROPATHIC PRACTICE. 

Hand Friction. 

This should be applied after all baths. It is preferable 
to any other kind of friction. In all cases where baths 
are made use of to invigorate the system, friction should 
be applied until reaction is produced. 

Temperature of Baths.* — Hot, warm, tepid, cool, 
and cold, are only employed as approximate terms. Water 
that feels hot to one may only be warm to another. The 
sensations are generally a better guide for regulating the 
temperature of a given bath than the thermometer ; 
still the latter is indispensable in many cases, and in all, 
convenient. As a general rule, the more feeble and deli- 
cate the patient, the more strictly should we follow the 
test of his feelings, in administering tepid, warm, or cold 
baths. When the circulation is vigorous, and the vital 
temperature well developed, we may regulate any bath 
with sufficient precision by the thermometer. It is a 
useful precaution, when commencing treatment with very 
susceptible patients, to test their sensibility to different 
temperatures of water, after which the physician or patient 
can prescribe them thermometrically. Some Water-Cure 
books seem to make it an especial point, to be thermo- 
metrically exact in directing particular baths for given dis- 
eases : as, for example, sitz baths, at 59° ; shallow-baths, 
at 63°; half-bath, 74°, &c. These nice distinctions are 
not to be arbitrarily imitated, but may be regarded as 
land-marks, to keep us within reasonable bounds. 

Baths may be distinguished into cold, below 65° Fahr. ; 
tepid, 65° to 80° ; warm, 80° to 98°. But a better 
division may be made thus : 



Very cold, 


32° to 40° 


Tepid, 


72° to 85° 


Cold, 


40° to 55° 


Warm, 


85° to 98° 


Cool, 


55° to 65° 


Hot, 


98° to 115° 


Temperate, 


65° to 72° 


Vapor, 


98° to 125° 



* Trail. 






CHRONO-THERMAL SYSTEM. 361 

ChronO'tkermal. — A system of medicine so called, from 
chronos, time, and therma, heat, first introduced by Dr. 
Dickson, of London, in 1836. He lays down the follow- 
ing propositions as the basis of his system : 

" 1. The phenomena of perfect health consist in a regu- 
lar series of alternate motions or events, each embracing 
a special period of time. 

" 2. Disease, under all its modifications, is, in the first 
place, a simple exaggeration or diminution of the amount 
of the same motions or events; and, being universally 
alternative with a period of comparative health, strictly 
resolves itself into fever, Remittent or Intermittent, 
Chronic or Acute ; — every kind of structural disorganiza- 
tion, from Tooth-Decay to Pulmonary Consumption, and 
that decomposition of the knee-joint, familiarly known as 
ivhite-siceUing, being merely developments in its course — 
Tooth-Consumption, Lung-Consumption, Knee-Consump- 
tion, &c, &c. 

"3. The tendency to disorganization, usually denomi- 
nated Acute, or Inflammatory, differs from the chronic or 
Scrofulous in the mere amount of motion and temperature ; 
the former being more remarkably characterized by excess 
of both, consequently, exhibits a more rapid progress to 
decomposition or cure ; while the latter approaches its 
respective terminations by more subdued, and, therefore, 
slower and less obvious terminations of the same action 
and temperature. In what does consumption of a tooth 
differ from consumption of the lungs, except in the differ- 
ences of the tissue involved, and the degree of danger to 
life, arising out of the respective offices of each V 

The remedies used in the treatment of disease, Dr. 
Dickson terms Chrono-Thermal, from the relation which 
their influence bears to time or period, and temperature 
(cold and heat) ; chronos being the Greek word for time, 
and therma for heat or temperature. These remedies are 
31 



362 CONSIDERATION OF FEVERS. 

all treated of in the various modern works upon the Ma- 
teria-Medica. The only agents this system rejects, are the 
bleeding lancet, the leech, and the cupping-instrument. 



PHYSIOLOGICAL, PATHOLOGICAL, 
AND PRACTICAL CONSIDERATION 
OF FEVERS. 

Pathological researches have not as yet been as suc- 
cessful in revealing the seat, nature, and character of 
fevers, as of some other diseases. This may be owing in 
part to the nature of the investigation. The investigation 
being mostly confined to autopsic appearances, while a 
correct physiological analysis of the symptoms manifested 
in the progress of the disease, has been in a great measure 
neglected. 

In order to arrive at a correct idea of the nature of 
fevers, a study of the causes, symptoms, and effects, pro- 
duced by the remedies, and the character of these pheno- 
mena, with those of organic modifications in a; state of 
health, with microscopic autopsic appearances, will enable 
us to arrive at a more just conclusion relative to all the 
pathological changes connected with fevers. 

The phenomena of fevers are so numerous and so dif- 
ferent in appearance, that it would be almost impossible 
to give a minute description of them. There is not a 
single derangement of function, or of tissue, which I have 
not observed in these diseases. They have then no specific 
symptom nor pathognomic sign ; even the hot skin, rigors, 
and accelerated pulse, exist in diseases when fever is not 
present. Although this is true relative to a single pheno- 
menon of fever, there are a series of phenomena, which is 
so uniformly present in what is termed idiopathic fevers, 
that we call the disease fever, when the symptoms are 
manifested in the following order : 



CONSIDERATION OF FEVERS. 303 

1. Nervous depression, characterized by languor, lassi- 
tude, and debility. 

2. Rigors and chills, connected with superficial capil- 
lary congestion, an irregular pulse, and hurried and op- 
pressed breathing. 

3. Reaction, characterized by a dry tongue, scanty 
urine, and loss of appetite. When these symptoms 
appear in the order in which they are here laid down, we 
denominate the disease fever. Although the above series 
of symptoms must always be present in the above order to 
constitute fever, it by no means includes the entire number 
of symptoms present in this disease. These symptoms 
indicate the disturbance of, or abnormal manifestation of, 

1. The nervous system, as indicated by the debility, 
lassitude, aversion to mental and physical exertions, rest- 
lessness, creeping chills, horripilations, alternations of 
flushing heat, and irregular breathing. 

2. A hurried and irregular action of the heart and 
arteries, dependent upon the abnormal nervous manifesta- 
tion. 

3. Immediately following this increased circulation of 
the blood, is an increased and abnormal temperature, a 
derangement of the secretions, as indicated by the scanty 
urine, dry tongue, hot skin, increased thirst, anorexia, 
&c, giving unmistakable evidence of the entire inability 
of the nervous system to afford these important organs 
the necessary stimulus. In thus carefully noting the series 
of changes which manifest themselves in all idiopathic 
fevers, we can commence at the derangement of the brain 
and nervous system, and follow the entire series of physio- 
logical and symptomatica! changes, as arising from, and 
dependent upon, the primary cause of this entire class of 
diseases, i. e., a derangement of the brain and its append- 
ages. 

In our classification of fevers, we have adopted that 



364 CONSIDERATION OF FEVERS. 

which appears to us to be the only one warranted by the 
manifestations of this disease. 

1st. Ephemeral Fever is the simplest of all forms of 
fever, yet it manifests the entire series of phenomena ; but, 
owing to the mildness of the cause, it lasts only twenty- 
four hours. The cure is effected by the recuperative 
powers of the system. 

The next form is that of Intermittent Fever, in which 
so much of the cause is removed as to relieve the nervous 
system for the time, but not entirely relieving the system 
from the morbid influences. During the thermal changes 
of the body in rest and sleep, the poisonous cause makes 
a sufficient impression upon the brain and nervous system 
to obstruct the proper supply of vital stimulus to the .de- 
pendent organs of the body, and the result is a repetition 
of the paroxysm or Intermittent Fever. If the shock 
received by the brain and nerves, is of sufficient intensity 
to prevent a temporary restoration and reaction, the fever 
is called Remittent or Continued. When the secretory 
and excretory system is so far deprived of the necessary 
stimulus as to produce an entire suspension of these func- 
tions, and the circulating organs are exceedingly languid 
from the same cause, the fever is called Typhus or Con- 
gestive Fever. When, in addition to these symptoms, a 
disorganizing tendency is manifested in the glands of the 
bowels, the fever is termed Typhoid. 

The condition of the capillary vessels in fevers, as recorded by 
David Craigie, M. D. y F. R. S. E., in his Pathological Ana- 
tomy, pp. 156 to 163. 

"In fevers, whatever be the form, intermittent, remit- 
tent, or continued, the capillary vessels are the seat of 
disorder. Nor is the affection confined to the capillaries 
of one region, of one organ, or of one tissue. The seat 
of fever is to be sought neither in the capillaries of the 



CONSIDERATION OF FEVERS. 365 

brain and spinal chord, nor in those of the kings, nor in 
those of the alimentary canal ; but it is diffused over the 
minute ramifying communications of the aortic and venous 
branches, in whatever part of the body these communica- 
tions are found. To establish the truth of this statement, 
it is requisite merely to consider the phenomena of fever 
in the living body, and its traces and effects in the dead. 

"I presume that the affection of the capillary system 
of the brain, both cranial and vertebral, is too generally 
admitted to require being formally demonstrated. In 
point of fact, the pain in the head in the beginning of all 
fevers, the derangement of thought during their progress, 
and the tendency to stupor, and absolute coma towards 
the conclusion, are sufficient alone to prove disorder of 
the cerebral capillaries. But when blood or serous fluid 
is found effused into the ventricles, when the vessels of the 
brain are found turgid, distended with blood, and more 
numerous than natural, it is impossible to resist the infe- 
rence as to the over-loaded state of the cerebral capillaries 
during life. I am aware that cases of fever are sometimes 
adduced, in which neither pain of the head nor deranged 
thought are observed. I can only say, that, among a 
very great number of cases which I have observed, though 
in a few the patient did not complain of headache, it was 
always possible to recognize more or less derangement of 
thought. 

"In all cases, pain is felt when the patient coughs or 
stoops, or when the head is slightly shaken ; and when no 
pain is said to be felt, it indicates that the stage of natural 
Sensation is passed, and that he complains not, because he 
does not feel. 

"In ague, the oppression of the cerebral cavities may 

be so great as to constitute inflammation (Siriasis iEgyp- 

tiaca), or phrenitic ague ; or, in various degrees, the sleepy 

quotidian, the sleepy, lethargic, hemiphlegic, carotic, and 

31* 



360 CONSIDERATION OF FEVERS. 

apoplectic tertian, and the comatose quartan of practical 
authors (Werlhof, Torti, La-utter, Sydenham, Morton, 
&c), the same disease which has been named by Lancisi, 
Baglivi, and Morgagni, epidemic apoplexy. 

" The disorder of the capillaries of the spinal chord is 
indicated by pain and weight in various parts of the 
column, by the derangement in the muscular motions, 
especially local palsy, e. g., of the arms, legs, &c, by the 
tetanic spasms and convulsions taking place in many 
fevers. After death, much serous fluid flows from the 
theca ; the vessels of the chord are distended and numer- 
ous ; in all instances, serous fluid is effused, and sometimes 
pure blood issues from its capillaries. 

"That the capillary system of the lungs is overloaded 
and oppressed in all fevers, is one of the most certain 
points in pathology. During the ague fit, the respiration 
is invariably quicker than natural, sometimes to the 
amount of thirty or thirty-six in the minute; the patient 
complains of s^nse of weight in the breast, cannot breathe 
fully, pants, and has frequent cough. In continued fever, 
the respiration is invariably quicker and more laborious 
than natural ; a deep breath cannot be drawn easily, and 
more or less sense of weight and oppression is felt. I 
have found the respiration in continued fever so quick as 
thirty-six in the minute, while in ordinary cases, the appli- 
cation of the stethoscope indicates an embarrassed state 
of the circulation in the pulmonary capillaries. In persons 
predisposed, expectoration, streaked with blood (hsemoptae), 
is not unfrequent during continued fever. 

11 The same conclusion is clearly established, by examin- 
ing the lungs of persons cut off either by intermittent 
or by continued fever, In many instances of the former, 
it induces bronchial inflammation, or proceeds to actual 
peripneumonia or pleurisy, constituting the catarrhal, 
pneumonic, or pleuric tertian respectively (Werlhof, Torti, 



., SIDERATION OF FEVERS. o()7 

Laneisi, &c). In the latter, the bronchial mucous mem- 
brane is always more or less red, sometimes crimson or 
purple, or of a deep brown color, rough and much thick- 
ened ; the sub-mucous tissue is brown and loaded with 
serous fluid ; and the minute vessels are much distended 
with dark-colored blood. The bronchial tubes are very 
commonly, in fatal cases, perfectly filled with thick, viscid 
mucus, which adheres to the inner surface of the bronchi; \ 
membrane. The serous surface of the organ is generally 
livid or marbled from this cause ; but the pleura itself is 
not much changed, save from the bloody serum discharged 
into its cavity. The lungs, in totality, are generally dense, 
and firmer than in the natural state. 

"These changes arise from the minute ramifying vessels 
at the termination of the pulmonary artery, and the organs 
of the pulmonary veins being unusually loaded with blood. 
As they are more so than can be readily affected by the 
ordinary quantity of air admissible in such a state, imper- 
fect respiration and undue change of venous blood con- 
tributes powerfully to the bad symptoms and the unfavor- 
able termination of the disease. In such a state of the 
organs of respiration, the bronchial arteries are less able 
to counteract the bad effects of imperfectly respired blood, 
in so far as they receive from the aorta blood which has 
not been sufficiently arterialized. 

"In the capillary system of the chylopoietic and assistant 
chylopoietic viscera, traces of the same condition may be 
recognized, both from the symptoms during life and its 
appearance after death. In these organs, two capillary 
systems may be distinguished, a primary and a secondary 
one. The primary is that which consists of the ultimate 
divisions of the splenic, gastric, and duodenal arteries, and 
of the superior and inferior mesenteric arteries, and their 
corresponding veins, which afterwards terminate in the 
splenic and superior and inferior mesenteric veins. The 



368 CONSIDERATION OF FEVERS. 

secondary capillary system is that which results from the 
union of the minute extremities of the portal vein, and of 
the hepatic artery with those of the vena cava hepatica. 

11 It is unnecessary to dvvellon the proofs of the loaded 
state of the capillary system of the alimentary canal. It 
is sufficient to remind the student that the furred or brown 
totfgue, the thirst, the sense of internal heat, the loathing, 
squeamishness, and sometimes sickness, with weight, op- 
pression, and tenderness of the epigastric region, suffi* 
ciently demonstrate the morbid state of the capillaries of 
the oesophagus, stomach, and duodenum ; while the consti- 
pation of the bowels at the commencement, insensibility 
to cathartic medicine throughout, and occasional looseness 
at the conclusion, indicate the deranged condition of those 
of the intestines. After death, the minute vessels of the 
whole of these parts are found much distended with blood/ 
generally dark-colored. 

"In one form of fever, the abdominal or intestinal 
typhus, the ileum and its mucous follicles are very much 
affected. The follicles become enlarged, elevated, and 
prominent, and swelled in consequence of their proper 
tissue being attacked, and perhaps their secreting pores 
being obstructed. The apices become dead, and are 
thrown off in the form of sloughs ; and in their place are 
left small ulcers, which, in no long time, enlarge, spread, 
and increase in depth. These changes may take place 
either in the isolated follicles, or in the aggregated patches, 
or in both orders of glands. 

"In certain forms of fever, there are pain, distension, 
and uneasy sensations in the right iliac region ; and when 
percussion is employed, the sound emitted is dull, while a 
peculiar croaking noise is heard, and a gurgling movement 
is felt beneath the fingers, as if produced by air and liquid 
moving within the intestine. 

(l These symptoms continue the greater part of the 



CONSIDERATION OF FEVERS. 369 

duration of the fever; and though they are abated by local 
depletion, by means of leeches aud and laxative medicines, 
they do not disappear until the fever itself either abates or 
altogether retires. 

" The portal vein constitutes, among the vessels of the 
digestive organs, a secondary capillary system, in which 
the blood is not less accumulated than in the primary one. 
It may be thought that, as the blood is accumulated in the 
first, it ought not so readily to find its way into the trunk, 
branches, and ramifications of the second. 

" But this objection will vanish, when it is remembered 
that, at the same time, both the primary and secondary 
system of capillaries become overloaded. This state of 
the capillaries of the portal and hepatic system is estab- 
lished by the appearance of the liver in persons cut off by 
fever. 

" The spleen may suffer so much from this capillary dis- 
tension as to resemble a mass of clotted blood without 
trace of organization. This morbid and extraordinary 
distension of the primary and secondary capillary systems 
of the chylopoietic organs, though distinct enough in the 
fevers of temperate countries, is most conspicuously de- 
monstrated in the agues and remittents of warm climates, 
and especially in the severe and extreme form termed 
yellow fever. In the former, great sickness and epigastric 
tenderness, with more or less vomiting, are frequent; and, 
in the latter, constant symptoms. The vomiting, however, 
is not bilious, as has been too generally imagined. It is, 
at the commencement, always a watery fluid, evidently 
derived from the capillaries of the gastric, and, perhaps, 
from the duodenal mucous membrane. After some time, 
it begins to be mixed with bile, expressed, no doubt, from 
the gall-bladder by the pressure of the stomach in the act 
of vomiting. A much more uniform occurrence, however. 
if the disease does not subside spontaneously, or is checked 



310 CONSIDERATION OF FEVERS. 

by art, is the gradual admixture of blood, somewhat 
darkened, with the watery fluid. This blood issues from 
the capillaries of the gastric and intestinal tissues by a 
process analogous to exhalation in the sound state, but 
differing in so far as, in the capillaries from which it pro- 
ceeds, a degree of disorganization has taken place. 

" As the blood escapes into the cavity of the canal, 
originally not highly scarlet, it is rapidly blackened by 
the action of the carbonic acid and sulphuretted hydrogen 
gases, at all times present in greater or less quantity. 
This bloody exudation is at first scanty, but gradually in- 
creases as the disease goes on, until it constitutes the 
greater part of what is discharged both by vomiting and 
by stool. In the former case, it forms the black-vomit or 
coffee-ground matter (vomito prieto), so frequent in cases 
of remittent or yellow fever. In the latter, it forms the 
dark, tarry, or treacle-like stools, mentioned by practical 
authors in the same disease. The description, now given 
is general, and applies to this capillary disorganization, 
as it takes place both in bad agues and remittents, and in 
yellow r fever. In the former it is less frequent, but, never- 
theless, takes place sufficiently often. In the latter, it is 
seen in its most aggravated form, and is almost invariable 
in fatal cases. Its origin and formation have been traced 
in the most satisfactory manner by repeated dissections. 

" The idea that black vomit is morbid or vitiated bile, 
deserve-s no attention. In some cases of severe yellow 
fever, a dark colored fluid of the same physical characters 
as those found in the intestinal tube, may be traced coming 
down the biliary and hepatic duct, from the pori biliarii. 
This, however, instead of being bile, is blood which has 
oozed from the hepatic capillaries, in the same manner as 
that from the intestinal ones. 

"The capillaries of the urinary system are much affected 



CONSIDERATION OF FEVERS. 371 

during fever. Both in intermittents and in continued 
fever, bloody urine has been discharged. 

"•'In the same manner, the capillaries of the muscles, 
of the filamentous tissue, and of the skin, are morbidly 
distended. One of the most common symptoms of fever is 
pain, soreness, and a sense of bruising in the muscular 
parts and limbs in general. In fatal cases, when these 
parts are examined by incision, unusual vascular distension 
and extravasation of blood are frequently seen. The livid 
spots and patches (molcepes; vibices ecchymosata) are 
proofs of the same state of the capillaries of the fila- 
mentous tissue, as petechial eruptions denote this in the 
skin. In short, there is scarcely a texture or organ of the 
animal body, the capillaries of which are not disordered 
in the different forms of fever ; and this disorder, instead 
of being confined to the capillaries of a single organ, is 
extended throughout the capillary system at large. 

"It is doubtless true, that in individual cases, this dis- 
order may be greater and more distinct in one set of 
capillaries than in another. In one set of patients, the 
capillaries of the brain may be most disordered ; in an- 
other, those of the lungs ; in a third, those of the intestinal 
canal ; and in a fourth, those of the urinary organs. It is 
always found, however, in such cases, that the affection 
of one organ does not entirely exclude that of another ; 
and while the capillaries of the one are very much affected, 
though those of the others are less so, they are by no 
means in the healthy state. In all cases of severe and 
exquisite fever, whether intermittent, remittent, or con- 
tinued, the capillaries of the brain, of the lungs and heart, 
of the chylopoietic organs, of the urinary organs, of the 
muscles, of the cellular tissue, and of the skin, are affected 
nearly in the same degree. 

"An important question is to decide the nature of this 



3?2 CONSIDERATION OF FEVERS. 

affection. The dissections of Home, Plocquet, Mills, 
&c, as to the brain ; those of Schenck, Morgagni, Lieu- 
taud, Sarconi, and others, as to the thoracic organs ; and 
those of Lieutaud, Petit, and Serres, Broussais, Lermi- 
nier, and Andral, Louis, Chomel, and Bright, as to the 
intestinal canal, might favor the supposition that the 
morbid process of fever consists in inflammation. 

"Against this conclusion, however, various facts and 
arguments may be added. 

" 1st. In fatal cases of fever, unequivocal traces of 
inflammation are not uniformly or invariably found. The 
proportion in which these marks, as albuminous effusion, 
suppuration, ulceration, &c, are observed, is small, com- 
pared with the number in which accumulation of blood iu 
the capillaries, and more or less disorganization of these 
vessels, are observed. 2d. In cases of pure, genuine, and 
unmixed inflammation of the internal organs, whether 
spontaneous or from injury, the concomitant symptoms, 
though febrile, are totally different from those that distin- 
guish either intermittent or continued fever. 3d. The 
marks or effects of inflammation, which are found in the 
bodies of persons cut off by fever, are accidental compli- 
cations, and may almost invariably be traced to inflam- 
matory reaction supervening on the febrile process, in 
consequence either of the physical peculiarities of the 
individual, the local weakness of the parts, or the influence 
of external morbific causes. 4th. Inflammation is a local 
action confined to the capillaries of one tissue, or at most 
of one organ and contiguous tissues ; and while the struc- 
ture and functions of the organ may be completely im- 
paired, those of others remain unaltered. In fever, on 
the contrary, the capillaries of all the tissues, and of every 
organ are affected ; and while no individual organ is much 
affected at the commencement, every organ suffers a little 
in the general disorder of the capillary system. 5th. 



CONSIDERATION OF FEVERS. 3*73 

Inflammation gives rise to albuminous exudation, suppura- 
tion, ulceration, and in certain parts, to serous, or sero- 
purulent effusion. In fever, the morbid state of the capil- 
laries terminates in complete destruction or disorganiza- 
tion of their organic extremities, and the consequent 
oozing of blood, from the surface of the several mem- 
branes and organs. 

In conclusion, though it may be regarded as established, 
that, during the morbid process of fever, the whole capil- 
lary system is unduly distended and loaded with an inordi- 
nate quantity of blood, which really moves more slowly 
and imperfectly than in health, we have no facts that 
enable us to determine what induces this peculiar and 
excessive accumulation. Much has been said lately of 
congestion, and especially of venous congestion. The 
state of the capillary system which I have attempted to 
describe is that of congestion or accumulation ; and so far 
the hypothesis of congestion is intelligible. Of the existence 
of venous congestion, however, unless as an effect of that 
in the capillary vessels there is neither proof nor proba- 
bility. It is not a primary, but a secondary, or rather a 
remote consequence." — (Marsh.) 

The Condition of the Blood in Fevers. 

11 It is obvious," says Dr. Carpenter, "that increase of 
fibrine in the blood does not exist as the result of fever." 

Dr. Andral has observed a marked diminution of fibrine 
in the blood in all idiopathic fevers ; he also found the red 
corpuscles and serum slightly increased. It is probable, 
however, that the increase of red corpuscle is relative in 
proportion to the amount of fibrine, and not in proportion 
to the entire bulk of the blood. "In typhoid fever, " says 
Dr. Carpenter, "the decrease in the proportion of fibrine 
is much more decidedly marked ; and that it does not 
depend upon abstinence from food, as, in all cases, as soon 
32 



374 CONSIDERATION OF FEVERS. 

as a favorable change occurs in the disease, the proportion 
of fibrine is much more decidedly marked." " In malig- 
nant forms of fever, " says Dr. Simon, "the blood frequently 
becomes so deteriorated in amount of fibrine as to com- 
pletely lose the power of coagulation." Another remarkable 
change which has been observed in the blood in Typhoid 
and other malignant forms of fever, is the want of due 
arterialization, as indicated by its dark blue appearance in 
the veins and arteries, as well as that of the capillaries. 
This being a very important one in a practical point, I 
will introduce the remarks of Dr. Cragie upon this subject : 

" What is the cause of these changes ? It is reasonable 
to think that for the cause we ought to look in the lungs 
chiefly. The lungs, I have already observed, are in all 
cases of fever more or less disordered, their vessels are 
congested and oppressed ; their action is impaired ; and 
there is proof of great derangement in the action of the 
bronchial membrane, imperfect admission of air to the 
bronchial tubes and their membranes, and, accordingly, 
inadequate arterialization, or, it may be, the lowest possible 
degree of that function. These may be regarded as matters 
of fact, capable of demonstration. Does this morbid state 
of the blood, then, begin in the lungs or in some other 
organ or set of vessels ? When we consider the large 
extent of the bronchial membrane ; the fact that, upon it are 
ramified the capillary divisions of the pulmonary artery ; and 
the fact that through these vessels passes the whole of the 
blood of the body ; and the further fact of the manifest 
disorder of the whole blood of the system in fever, it is 
impossible to resist the conclusion, that it must be chiefly, 
perhaps solely, on the blood of the lungs that the cause of 
the fever begins to display its primary and initial operation. 

" On the nature of this cause it is not possible to speak 
with confidence or certainty. But if the general opinion 
that it is a poison diffused through the air, be well founded, 



CONSIDERA-TION OF FEVERS. 315 

it is not difficult to perceive at least some traces of its mode 
of operation. Whether that poison be extricated in the 
form of a vapor or exhalation from the surface of the earth, 
and is telluric in its origin ; or is eliminated from vegetable 
matters in certain circumstances of decay or change ; or 
from vegetable and animal matters conjoined ; or is given 
off as a subtle effluvium from the bodies of living human 
beings, in circumstances unfavorable to ventilation and the 
healthy performance of the functions ; or is the result of 
some unknown and inappreciable state of the atmosphere; 
— it must equally be inhaled in the air in inspiration, and 
thus thoroughly mixed with the blood of the lungs in suc- 
cessive acts of the function of respiration. If it be so 
mixed, it must be circulated with the circulating blood, 
and in this manner distributed through the whole vascular 
system to every organ of the body, In doing so, however, 
this poisonous material will have so altered the blood in 
the lungs as to produce in that blood, and in these organs, 
a more decided effect than elsewhere. The shock first 
inflicted on the blood in these organs appears, it is natural 
to think ; the great cause of the loss of coagulating pow r er 
and the impaired arterialization. We know that one of 
the great uses of the lung, next to or along with the 
arterialization of the blood, is to maintain the coagulating 
power, and restore it when impaired. It is, therefore, 
natural to infer, that when the coagulating power is dimin- 
ished, it depends upon some important impediment to the 
function of respiration, and that when the function of respi- 
ration is imperfectly performed, that it should evince its 
effects in a diminished proportion of coagulating power. 

If these views be well founded, it follows that, when the 
blood thus altered is circulated, however imperfectly, it 
must operate hurtfully on the organs to which it is trans- 
mitted. It must act, in truth, as a poison, and many of 
the phenomena of fever are similar, certainly, to the effects 



3tG CONSIDERATION 0*F FEVERS. 

of poison, especially a poison at first irritant, and then 
sedative and narcotic. This appears to be the mode in 
which, towards the latter stage of fever, its cause acts on 
the brain and spinal marrow. H 

The ancients supposed fever to depend upon a warfare 
between the vital forces of the body and some noxious 
element which had invaded the system. 

Hippocrates ascribed the different fevers to the four 
humors ; blood, phlegm, and yellow and black bile. Galen 
supposed that the different forms of ague depended upon 
the corruption of the different fluids. That quotidian 
arose from the corruption of phlegm, the tertian from the 
corruption of yellow bile, and the quartan from that of 
black bile. He also supposed that, in whatever part of 
the body the heat began, it ultimately terminated in the 
heart, causing increased motion of the blood and accelerated 
pulse, followed by an effort of the vis vitas to expel the 
poisonous agents from the system, and to assimilate the 
healthy fluids to sustain the different organs of the body. 
Sydenham says, "that reason dictates that a fever is 
nothing else than an effort of nature to thrust from the 
system morbific matter, in order to restore the patient to 
health ; that seeing it has pleased God, the Governor of 
all things, so to constitute human nature as to be subject 
to a variety of diseases ; that these diseases are introduced 
into the system in the form of poisoned air and otherwise, 
and that when once introduced into the system they become 
so identified with it that it is beyond the art of man to 
separate it, hence nature has provided for herself a method 
and concatenation of symptoms, so that she might thereby 
expel the poisonous matter which would otherwise ruin the 
whole fabric. Avicenna attributed the phenomena of fever 
to the superabundance of the different humors. Dr. Stahl 
maintained that fevers depended upon plethora or over- 
fulness of the vessels, and a depraved condition of the 



CONSIDERATION OF FEVERS. 311 

fluids. Hoffman maintained that fever consisted in a spasm 
of the capillaries. He attributed the cause of these spasms 
to some morbid affection of the nervous system. Cullen 
contended that fever depended upon certain abnormal 
changes occurring in the brain. Dr. Benjamin Huso, that 
all diseases are a unit ; and that fevers, as well as other 
diseases, depend upon an irregular action, and this irregular 
action, in its turn, is the proximate cause of every form 
and modification of disease. Ploucquet claimed that all 
fevers were dependent upon inflammation of the brain. 
Broussais that all fevers depended upon an altered condi- 
tion of the mucous surface of the stomach and bowels. 
That this alteration was mostly confined to the mucous 
follicles ; and that, as the disease advanced, they passed into 
a state of suppuration. Relative to the opinion of Brous- 
sais, Dr. Andral remarks as follows: ''Admitting that 
simple or follicular enteritis is the commencement of a 
great number of fevers, can everything be explained by 
them ? We never thought so ; and it has always appeared 
to us that these fevers never become severe except in con- 
sequence of a disturbance which supervenes in the innerva- 
tion and hematosis. This has been very satisfactorily 
proved by Prof. Bouillaud, who has contributed to give 
considerable weight to the doctrine of the localization of 
fevers, by placing this doctrine on a broader basis, more 
particularly by establishing the reality of the alterations, 
which on the one hand the blood, and on the other the 
nervous centres, undergo in a great number of fevers. The 
part performed by these has been also clearly demonstrated 
by the valuable observations of M. Chaufford, of Avignon. 
This disturbance of hematosis and innervation, which 
gives rise to the phenomena called adynamic and ataxic, 
or in other words, to the typhoid state, may be the result 
of several lesions, different in their nature and in their 
seat. 

32 * 



SIS CONSIDERATION OF FEVERS. 

First, gastro-intestinal inflammations give rise to it more 
frequently than diseases of an}' other organ. Of these 
inflammations, some are directed principally to the intesti- 
nal follicles, which become tumefied, and ulcerate ; others 
consist merely in a simple ulceration of the mucous mem- 
brane itself. Other organs also, however, though less 
frequently than the digestive tube, may become the occasion 
of that profound disturbance of innervation and hematosis, 
a disturbance which constitutes the adynamic and ataxic 
fever of Pinel. Thus phlebitis, pneumonia, particularly in 
aged persons, erysipelas, phlegmon, inflammation of the 
urinary passages, an abscess developed in the prostate, 
metritis, several forms of inflammation of the liver, variola, 
acute inflammations of the synovial membranes, etc., may 
give rise to it. M. Boisseau has clearly proved this in 
his physiological pyretology, and it has been put out of 
all doubt by several other works ; by those of Pance, in 
particular. 

Thus the ataxo adynamic, or typhoid state, may be de- 
veloped, in consequence of a great number of affections 
widely differing from each other : it is a collection of 
symptoms identical as to their ultimate seat, but not as to 
their origin. Thus symptoms, identical also as to their 
nature, differ only in their greater or less intensity ; with 
regard to their progress and duration, they are subordinate 
to the progress and duration of the affection, in conse- 
quence of which the typhoid symptoms have been de- 
veloped. If it be a primary alteration of the blood which 
gives rise to them, these symptoms may acquire, in a few 
hours, their highest degree of development; and, in some 
cases, even occasion sudden death. If the commencement be 
in an organ where inflammation is rapidly developed, as in 
a lung, or in a vein, the typhoid symptoms shall have a 
quick course and a rapid termination, similar to this in- 
flammation. If, on the contrary, they are connected with 



CONSIDERATION OF FEVERS. 3T9 

an inflammation, which, as that of the intestinal follicles, 
has stages, which it passes through with a certain degree 
of slowness, they will be like the inflammation itself, slow 
in their development, and slow in their termination, 
whether favorably or fatally. 

This is, we think, all the difference between a typhoid 
fever, which is connected with phlebitis, for instance., 
and that which follows dothiteritis. There will be, 
however, in each of them, some particular symptoms, 
which will depend on the local lesion, as the diarrhoea in 
the case of follicular enteritis. We may, no doubt, as M. 
Louis has done, reserve the term typhoid fever for the 
morbid state which proceeds along with the affection of 
Peyer's glands; this, however, is a distinction purely 
arbitrary ; and, besides this mode of proceeding., seems to 
us to be attended with the inconvenience of thus desig- 
nating a great number of cases' of follicular enteritis, in 
which the term typhoid affection has no longer any mean- 
ing ; for all cases of follicular enteritis, certainly are not 
accompanied either with stupor, or with the different phe- 
nomena of adynamic or ataxic fever ; all do not resemble 
typhus : they are oftentimes mere inflammatory, bilious, or 
mucous fevers, to use for a moment the language of the 
Nosograph ie Philosophique. 

We do not think it right then to retain the term typhoid 
fever, because this term leaves a vagueness in the mind, 
not consistent with science, and because it often fails in ex- 
actness, with respect to the symptoms which it represents. 
We admit as a possible, but never a necessary consequence, 
a typhoid state in a great number of diseases ; that is to 
say, a state in which there appear some general symptoms 
more or less similar to those which characterize typhus. 
This state indicates that the disease no longer exists in the 
organ where it had commenced — it i^, in some degree, the 
signal that the blood and nervous centres participate in 



380 CONSIDERATION OF FEVERS. 

the disease. Thenceforward, the nature of the disease is 
no longer the same, and other therapeutic indications 
present themselves to be fulfilled. 

The term typhoid, when applied to fevers in this work, 
is not used as an adjective, defining typhus, but as a noun, 
the name of a fever which is characterized by a specific 
glandular affection of the bowels. Dr. Samuel Dickson, 
of London, donounces, in the most emphatic terms, the 
opinion entertained by the great body of the medical pro- 
fession, that not only fevers, but all other diseases, are very 
various, and may be developed by a plurality of causes ; 
and adopts the maxim of Hippocrates, " Omnium mor- 
borum units et idem modus est." The type of all dis- 
eases is one and identical. Upon this subject he remarks, 
"a disease is not a devil to be cast out, an acrimony or 
crudity to be expelled, nor any fanciful chemical goblin 
to be chemically neutralized ; neither is the state errone- 
ously termed inflammation, so commonly the cause, as a 
coincident part of the general disorder. Disease is an 
error of action ; a greater or less variation in the motion, 
rest, and revolutions of a systematic series of periodic 
alternations. 

Whatever be the cause or causes of corporeal aberration, 
in obedience to the law of all matter, the first effects are 
changes of motion and changes of temperature ; the patient 
accordingly has a feeling of heat and cold ; his muscular 
movements are less under the control of their respective 
influences, thus becoming tremulous, spasmodic, or varied. 
The breathing is irregular ; the heart beats with increased 
force, and often with much irregularity of motion. The 
secretions are changed. The functions of the brain are 
disturbed, and the body undergoes material physical 
changes. He further states the cause of all disease, of various 
name, place and degree, is only one in their real nature, 
and may be found in a deprivation of any adapt ntion of 



CONSIDERATION OF FEVERS, 381 

the identical forces which continue life in health ; the same 
natural agencies, in a word, by which every motion or 
event is produced throughout the universe. They com- 
prise everything, therefore, which connects us directly or 
indirectly with the external world. The cause of disease, 
then, never originates in any single organ of the body, ex- 
cept as far as that organ may be predisposed by inherent 
weakness of the attractive powers of the atoms of its parts 
to receive grave impressions from outward agencies that 
affect other parts of the body in a slight manner. He 
claims health to consist in a periodic alternation of har- 
monious molFlments, some longer, some shorter, and that 
intermittent fever is the type of all diseases ; in other 
words, that all diseases are but a modification of fever, of 
which ague is the type. 

Whether this doctrine of fever, according to Dr. Dick- 
son, be true, and that every fever is but a modification of 
the primitive type, ague, is a subject worthy of investiga- 
tion. The opinion of Prof. J. G. Jones, that disease, 
throughout the entire western country, is decidedly of a 
periodic character, with the almost universal success of 
antiperiodie remedies in its treatment ; and not only that 
which is acknowledged to be of an intermittent type, but 
also that which is supposed to depend upon a series of 
uninterrupted morbid changes, is a confirmation of the 
doctrine of the periodicity of disease, at least to a certain 
extent. 

Also the doctrine of disease as advocated by my learned 
colleague, Prof. Chase, M. D., which is, that disease de- 
pends upon the too positive or too negative condition of 
the electrical forces of the brain and nerves, or cerebral 
spinal system ; and that these alternate changes in the 
electrical condition of the nervous system give rise to all 
the pathological changes characteristic of not only fever, 
but all other diseases. He maintains that all medicine 



382 CONSIDERATION OF FEVERS. 

acts upon the system in increasing or diminishing the 
positive or negative electrical condition of the brain and 
nerves. Also that medicines are beneficial in proportion 
as they regulate the positive and negative electrical forces 
of the body. These views being true, we can harmonize 
the doctrine of Dr. Dickson with the manifest phenomena 
of fever. The limits of this, work will not allow of a 
further consideration of the nature of fever, but the subject 
will be fully considered in my large work, now in the 
course of preparation, upon the Principles and Practice 
of Medicine. 

The anatomical character of fever varies wfth the type 
of the disease. In intermittent, autopsy has shown traces 
of inflammation of the arachnoid membrane of the brain. 
The liver is frequently the seat of lesion, and sometimes 
undergoes a change of structure. In chronic ague, it pre- 
sents the appearance described by Dr. Craigie, caused by 
the congested condition of its capillaries. But of all the 
organs of the body, the spleen is the most uniformly affected. 
It is not only changed in structure, but becomes very much 
enlarged, and in all fatal cases proves to be the principal 
organ on which the disease has spent its force. In remit- 
tent and congestive fevers, the essential anatomical charac- 
ter is alteration in the condition and structure of the liver 
and gall-bladder, although other organs, such as the spleen, 
lungs, brain, and we might add the entire capillary system, 
at times manifest organic lesion and congestion. 

In typhoid fever the principal anatomical characteristic 
appears to be confined to the glands of the bowels. On 
summing up the locality of fevers, w^e may reasonably 
infei; that the intermittent form is intimately connected 
with a deranged condition of the spleen, while the remit- 
tent and congestive spend their force upon the liver and 
stomach, and typhoid upon the bowels. Yet it is contrary to 
the universal characteristics of all forms of fever, to confine 



ECLECTIC REMEDIES. 383 

their anatomical and physiological changes to any definite 
boundary, as each and every organ of the body is neces- 
sarily more or less dependent upon the entire organism 
which constitutes the whole. So disease, although local 
in its incipiency, soon extends its abnormal influence to 
nearly, if not every, tissue of the body. 



METHOD OF PREPARING ECLECTIC 
REMEDIES. 

All the concentrated remedies which are prepared in a 
powdered form, should be triturated either with sugar of 
milk or pure white sugar. The object of this is, 1st, to 
prevent the local influence of the medicine upon the 
stomach ; 2d, it enables it to become- more readily ab- 
sorbed and conveyed into the circulation, to perform its 
mission of removing disease, as it passes through the dif- 
ferent tissues, with the blood. All the fluid extracts should 
be diluted with pure syrup of sugar, in the same propor- 
tion as the powdered materials, i. e., ten parts to one 
hundred of the syrup. The tincture should be given largely 
diluted with soft water. The triturations, tinctures and 
syrups, should all be thoroughly prepared and well secured 
from light, moisture and heat. They should be kept in 
ground-stopper jars, and should be prepared as often as 
once or twice-a year. My recipes in this work are full doses 
for an adult, or what might be considered a medium dose. 
To enable the prescriber to proportion the dose to the age, 
sex, idiosyncrasies, temperament, &c, I introduce the fol- 
lowing table from the A. E. W, p. 1315. 



384 



TABLE OP DOSES. 



Table of Proportionate Dose for Different ages. 



Under J year, 

1 " 

2 " 

3 " 

4 « 
7 " 

14 " 

20 " 

21 " 
63 " 
77 " 

100 " 



one-fifteenth of a full dose, 

one-twelfth " 

one-eighth u 

one-sixth " 

one^fifth " 

one-third " 

one-half " 

two-thirds " 
the full dose 

eleven- twelfths " 

five-sixths " 

two-thirds u 



4 grains. 
5 

n 

10 

12 

20 

30 

40 

1 drachm. 

55 grains. 

50 " 

40 " 



To the above rule there are certain exceptions ; thus 
castor oil requires to be given in larger proportionate 
doses, while opium, and the narcotics generally, should be 
administered in smaller proportionate doses. 

Sex, temperament and idiosyncrasy, have also a modi- 
fying effect upon the dose, and they should always be kept 
in view in the administration of medicines. 

Females usually require smaller doses than males ; and 
persons of a sanguine temperament bear depletory medi- 
cines better than the phlegmatic. 

Explanations of the Abbreviations occurring in the For- 
mulas of this Work. 



R. 


Recipe — Take. 




lb. Libra — Pound. 


M. 


Misce — Mix. 




g. Uncia — An ounce. 


gr. 


granum— A grain. 




5. Drachma — A drachm or dram 


O. 


Octarius — Pint. 




Gutt. Gutta — Drop. 


ss. 


Semi— A half. 




Tinct. Tinctura — A tincture. 


aa 


of each ingredient equal pi 


irt$. 


Ext. Extractum — An Extract. 



MEDICAL TERMS. 385 



GLOSSARY OF MEDICAL TERMS EMPLOYED IN 
THIS WORK. 

Abdomen. The cavity situated between the lower part of the 
thorax and the region of the pelvis, containing the intestines, &c. 

Abnormal. Unhealthy. 

Abortion. Miscarriage. 

Abrasion. Excoriation. 

Abscess. Cavity containing pus. 

Absorbents. The lacteals and lymphatic vessels. 

Absorption. The act of taking or sucking up. 

Acacia. Gum Arabic. 

Acarus Scabiei. The itch insect. 

Acetate. A salt containing acetic acid, united to a base. 

Acetic Acid. Vinegar. 

Acetic Tincture. A tincture made with vinegar. 

Acid. A compound body which neutralizes alkalies and other 
bases. 

Aconite, Monk's-hood. A native of Europe. This plant is culti- 
vated in gardens as an ornament. It is very extensively used by 
Eclectics as a febrifuge. 

Aconitum Napellus. 

Acme. The heighth of a disease. 

Acne. Small red pimples appearing upon the face, mostly of 
young persons. 

Adhesive Inflammation. That kind of inflammation which glues 
parts together, by means of coagulable lymph. 

Adipose. Fatty. 

Ether. The name of the oxyde of Ethyle. 

Afferent. Name of lymphatics conveying lymph to the glands ; 
also, nerves which convey impressions to the brain. 

Afflux. The act of flowing to. 

Ague-Chill. The cold stage of an intermittent. 

Albumen. A substance found in animals and vegetables, and 
which constitutes the chief part of the white of eggs. 

Alcohol. The rectified spirits of wine. 

Aletris Farinosa. Star-grass. 

Aliment. Any kind of food. 

Alimentary Canal. The entire passage through which the food 
passes from the mouth to the anus. 
33 



386 GLOSSARY OF 

Alkali. A substance, having a metallic base, which neutralizes 
acids, as potash, soda, and ammonia. 

Allopathy. The system of curing one disease, by substituting 
another. 

Aloes. The inspissated juice of the aloe spicata. 

Alnuin. Concentrated remedy from the swamp alder. 

Alteratives. Medicines intended to change the morbid action by 
restoring the healthy functions of the secretions, &c, by a gradual 
process. 

Alum. Super sulphate of alumina and potash. 

Alvine. Relating to the intestines. 

Amaurosis. A paralysis of the optic nerve. 

Ammonia. Volatile alkali. 

Amphoric. A sound, like blowing into a decanter, heard in aus- 
cultating the chest in certain diseases. 

Amenorrhcea. Absence of the menses. 

Ampelopsin. A concentrated remedy from the woodbine. 

Anaemia. An impoverished state of the blood. 

Analysis. Resolution of a compound body into its elements. 

Anasarca. Dropsy of the cellular tissue, or membrane, beneath 
the skin. 
5 Aneurism. Morbid enlargement of an artery. 

Angina. Generic name of morbid affections of the throat. 

Anorexia. Want of appetite. 

Anthelmintic. A worm-medicine. 

Antidote. A medicine given to destroy a morbid cause. 

Antimony. A metal used in medicine. 

Antiperiodic. A remedy for periodic diseases, as ague. 

Antiphlogistic. A remedy for inflammation. 

Antiseptic. A preservative from putrefaction. 

Anus. The inferior opening of the rectum. 

Aorta. The large artery passing off from the heart. 

Aperient. A gentle purgative. 

Aphonia. Loss of voice. 

Apthus. Sore patches on the mucous membrane. 

Apocynin. A concentrated remedy prepared from the bitter root. 

Apoplexy. Hemorrhage into the brain. 

Apyrexia. Intermission, or absence of fever. 

Arachnoid. Web-like membrane covering the brain. 

Areolae. The interstices between fibres composing organs. 



MEDICAL TERMS. 387 

Arnica Montana. Leopards' bane ; a remedy used in intermittent 
fever, &c, and for mechanical injuries. 

Artery. The name of a blood vessel which conveys blood from 
the heart. 

Arthritis. Gout. 

Assafoetida. The inspissated juice of a plant growing on the 
shores of the Mediterranean. 

Ascarides. Small worms infesting the rectum. 

Ascites. Dropsical effusion within the abdomen. 

Asclepin. Concentrated remedy obtained from the pleurisy root. 

Asphyxia. Apparent death from suffocation. 

Asthenic. Applied to disease of a low grade of action. 

Asthma. A disease of the lungs, accompanied by difficult 
breathing. 

Astringents. Medicines used to contract the animal fibre. 

Atony. A want of tone or energy in the muscular power. 

Atrophy. A morbid state of the digestive system, in which tire 
food taken into the stomach fails to afford sufficient nourishment. 
A wasting of the whole or different organs of the body. 

Auricles. The superior cavities of the heart. 

Aurium, Tinnitus Ringing in the ears. 

Auscultation. Method of detecting disease by listening to the 
abnormal sounds produced in the lungs, in inspiration and expira- 
tion, by direct application of the ear, or by means of a hollow tube 
applied to the chest, called a stethoscope 

Axilla. The arm-pit. 

Balcony. Chelona Glabra, Snake's-head, Bitter Herb. Exten- 
sively used as a stomachic and tonic. 

Balsam Copaiva. Liquid resin used for chronic inflammation of 
the mucous membrane. 

Balsam of Tolu. Liquid resin used for coughs and catarrhal af- 
fections. 

Baptisin. A concentrated remedy, prepared from the wild indigo 
or Baptisia Tinctoria. 

Battery, Galvanic. A connected series of zinc and copper plates, 
alternately arranged, with acid and water. 

Bayberry. An astringent plant used as a tonic and astringent. 

Beeberine. Active principle of the bark of the Beeberu. 

Belladonna. Deadly Night Shade. 

Bellows sound. A sound produced in the lungs and heart, analo- 
gous to a bellows. 



388 GLOSSARY OF 

Berberin. Active principle of the barberry ; antiperiodic, tonic 
and laxative. 

Benzoic Acid. Flowers of Benzoin. 

Bicuspides. The first grinding teeth, molars. 

Bifurcate. To divide into two branches. 

Bile. A yellowish fluid secreted by the liver ; its use is to re- 
move from the fluids superfluous hydro-carbons. 

Bistoury. Small knife used by surgeons. 

Bitartrate of Potassa. Cream of tartar. 

Bleb. Small blister. 

Borax. Salt of boracic acid and soda, sub-borate of soda. 

Bronchi. The tubes into which the trachea or windpipe divides. 

Bougie. Small elastic rod for dilating strictures of the urethra ; 
also for evacuating the bladder. 

Bronchitis. Inflammation of the ramifications of the wind-pipe. 

Bronchial Sound. Sounds heard over the bronchi. 

Bronchophony. Resonance of the voice heard over the bronchial 
tubes, or conveyed through a consolidated lung, or through an 
accumulation of fluid. 

Bronchocele. Enlargement of the thyroid gland. 

Bryonia. Medicine used in typhoid fever. 

Bubo. Inflamed gland occurring in the groin or axilla. 

Cadaverous. Countenance resembling a corpse. 

CsQCum. The head of the colon ; so-called from being perforated 
at one end only. 

Cajeput. Volatile oil used for rheumatism, &c. 

Calculus. Stone in the bladder. 

Calomel. Combination of chlorine and mercury; a proto-chlo- 
ride. 

Camphor. A valuable antispasmodic and nervine. 

Cannabis Indica. Indian hemp. 

Canula. A hollow tube. 

Cantharides, Spanish flies, , for blistering; used extensively by 
allopaths and homoeopaths. 

Capillaries. Hair-like vessels for conveying the blood from the 
arteries to the veins. 

Capsicum. Bed pepper, Cayenne ; pure stimulant, used in two or 
three grain doses, whenever a stimulant is indicated. 

Carbo-ligni. Charcoal ; carbo-vegetabilis. 

Carbonates. Combinations of carbonic acid, with a base. 

Cardiac. Appertaining to the heart. 



MEDICAL TERMS. 389 

Cardialgia. Pain in the stomach. 

Carditis. Inflammation of the heart. 

Caries. Disease of the bone. 

Cartilage. Gristle. 

Carotid. Name of the artery passing up each side of the neck, 
conveying the blood to the brain. 

Castor. A secretion found in a sac near the anus of the beaver. 

Catalepsy. A nervous affection, involving loss of consciousness. 

Catamenia. The menstrual flux. 

Cataplasm! A poultice. 

Catarrh. Flow of mucus. 

Catharsis. Purging. 

Cataract. Opacity of the crystalline lens. 

Catheter. A hollow silver tube used for evacuating the bladder. 

Caulophyllin. The active principle of the blue cohosh. 

Caustic. A substance which destroys parts by combining chemi- 
cally, or disorganizing them. 

Ceanothus. New Jersey tea. 

Cellular Tissue. The fine or net-like tissue connecting most of 
the structures of the human body. 

Cephalitis. Inflammation of the brain. 

Cephalome. A morbid tumor, the matter of which resembles the 
brain. 

Cerate. An ointment made of wax. 

Cerasin. Active principle of the choke-cherry; used very exten- 
sively as an antiperiodic and febrifuge ; the medium dose from three 
to five grains, repeated every two or three hours until thirty or forty 
grains are given. 

Cerebellum. The posterior portion of the brain. 

Cerebrum. The anterior portion of the brain. 

Cerebritis. Inflammation of the brain. 

Cervex Uteri. Neck of the womb. 

Chalybeate. Containing iron. 

Chancre. Syphilitic ulcer. 

Chelona Glabra. Snake's head, balmony. It is tonic and vermi- 
fuge, used in the form of infusion. 

Chelonin. The active principle of the chelona glabra. 

Chlorine. An elementary gas. 

Chlorosis. Green sickness. 

Cholerine. A modified species of cholera. 

Cholera Morbus. Bilious vomiting and purging. 
33* 



390 GLOSSARY OF 

Cholera Infantum. Summer complaint of children. 

Chorea. St. Vitus' dance. 

Chyme. The pulp formed by the food mixing with the gastric 
secretions, after it has been for some time in the stomach. After 
the chyme becomes mixed with the pancreatic and biliary secretions 
of the duodenum, it is converted into chyle. 

Cicatrix. A scar. 

Cicatrization. Process of healing. 

Cicuta. Poison hemlock. 

Cicutin. The alkaloid of cicuta. 

Cimicifugin. The concentrated principle of the black snake-root. 

Cinchona. Peruvian Bark. 

Cinchonine. An alkaloid of the cinchona. It is antiperiodic, and 
used in the same cases as quinine. 

Citric acid. Acid of lemons. 

Clinic. A school in which medicine is taught by examining 
diseased patients at the bedside. 

Clysters. Injections per ano and per vagina. 

Cnicene. One of the active principles of the blessed thistle. 

Coagulum. A clot of blood or milk. 

Coffea, Coffee. A homoeopathic remedy for nervous diseases. 

Colchicin. The alkaloid of colchicum autumnale. 

Cold. Catarrh in the head. 

Colic. Griping in the intestines. 

Colitis. Inflammation of the mucous membrane of the colon. 

Collapse. Kecession of blood from the superficial capillaries, and 
failing of the vital powers. 

Colliquative. Excessive evacuation. 

Colombin. Proximate principle of columbo. 

Colon. The large intestine. 

Coma. Drowsiness, lethargy. 

Comatose. Drowsy. 

Compatibles. Medicines which can be used together without im- 
pairing their properties. 

Confluent. Running together ; one variety of small-pox. 

Congenital. Being present at birth. 

Congestion. Over fulness of the blood-vessels. 

Congestive Diseases. Those in which congestion is the most 
prominent symptom. 

Congestive Fever, is a fever, where the stomach, liver and spleen, 
are the congested organs. 



MEDICAL TERMS. 391 

Conjunctiva. The outer membrane of the eye. 

Conjunctivitis. Inflammation of the conjunctiva. 

Constipation. Costiveness. 

Constitutional. Hereditary, or acquired predisposition ; a disease 
is said to be constitutional when it affects the whole system. 

Consumption. Wasting away. 

Contagion, Propagation of disease by contact. 

Continuity. Direct connection ; identity of surface. 

Cornea. The horny transparent coat of the eye. 

Corneitis. Inflammation of the cornea. 

Cornus Florida. Dog-wood. 

Cornine is the active principle of the cornus Florida, and is 
used as a substitute for quinine. 

Corrugated. "Wrinkled. 

Corydalin. The active principle of the Turkey pea ; it is a spe- 
cific remedy for syphilis. 

Critical. Applied to certain symptoms, and certain stages of 
disease indicating crisis. 

Croup. Inflammation of the trachea. 

Cutis Anserinus. Goose-skin. 

Cynanche. Any inflammatory disease of the throat. 

Cypripedin. The active principle of the lady-slipper. 

Cystitis. Inflammation of the bladder. 

Decoction. Preparation made by steeping. 

Decomposition. Dissolution of the animal tissue. 

Decubitus. Lying down. 

Deglutition. The act of swallowing. 

Delirium. Aberration of the mind. 

Delirium Tremens. Disease produced by excessive use of intoxi- 
cating liquors. 

Dementia. Loss of mind ; idiocy. 

Dental. Appertaining to the teeth. 

Dentition. Process of cutting the teeth. 

Depletion. Diminishing the fulness of a part, by evacuating re- 
medies. 

Derangement. Applied to functional disturbances of the organs. 

Dermoid. Resembling the skin 

Desiccation. Drying, scabbing. 

Desquamation. Scaling off. 

Determination. Unnatural flow of blood to the part. 



392 GLOSSARY OF 

Diabetes. Disease characterized by mal-assimilation and saccha- 
rine urine. 

Diagnosis. Distinction of maladies. 

Diagnostic. Characteristic of disease. 

Diaphorous. Transparent. 

Diaphoresis. A gentle perspiration. 

Diaphoretic. Medicines having a tendency to excite perspiration. 

Diaphragm. The partition separating the thorax from the abdo- 
men. 

Diarrhoea. Looseness of the bowels. 

Diastole. A periodical dilatation of the heart and arteries, when 
the blood enters their cavities. It is the opposite movement to 
cystole, in which the heart and arteries contract to send forth the 
blood. 

Diathesis. Constitutional tendency. 

Digestion. Conversion of food into blood. 

Digitalis. Fox-glove. 

Digitalin. A concentrated preparation from the digitalis ; it is 
diuretic and sedative ; from one-fifth to one-half grain is a dose. 

Dilatation. Widening. 

Dioscorea Villosa. Yam-root. 

Dioscorine. The active principle of the yam-root ; a specific for 
bilious colic. 

Discutient. A repelling medicine. 

Disorganization. Destruction of an organ. 

Dissection. The anatomical examination of the parts of the body. 

Diuresis. An increased flow of urine. 

Diuretic. Medicine which increases the secretion of the urine. 

Dorsal. Pertaining to the back. 

Drachm or dram, g. Sixty grains by weight, and an ordinary 
teaspoonful by measure. 

Drastic. Powerful purge. 

Dropsy. Effusion of serum into any of the cavities. 

Drug. A medicine which has not undergone a preparation. 

Duct. A canal for conveying fluids. 

Dulcamara. Bitter-sweet. 

Dura-mater. The outer membrane of the brain. 

Dysentery. Inflammation of the colon. 

Dysmenorrhoea. Painful menstruation. 

Dyspnoea. Difficulty of respiration, shortness of breath. 

Dysuria. Difficulty in passing urine. 



MEDICAL TERMS. 393 

Ecchymosis. Effusion of blood beneath the skin. 

Eclectic Physicians. Those who select their remedies from all 
the systems of practice. 

American Eclectic Physicians. This refers to a large class of 
physicians, "who believe that the investigation and practice of medi- 
cine shall be free. That all remedies should be applied that can be 
of any utility in removing disease, no matter from what system they 
may be derived. They also claim that the science of medicine is 
progressive, and that no dogmatic creed should be adopted to im- 
pede its progress. By the Eclectic profession, the valuable reme- 
dies of the other systems have not only been adopted, but a large 
number of new ones are introduced, which enable them to combat 
disease with far greater success than by any exclusive system. 

Eczema. Eruption on the skin. 

Efferent. To carry. Efferents may be the lymphatics, blood- 
vessels, or nerves. 

Effusion. Pouring out of blood, or any other fluid, into the 
areolar membrane or cavities of the body. 

Effete. Worn out, 

Egophony. A sound heard when the lung is hepatized, or the 
pleural sac partly filled with fluid ; when the voice strikes the ear 
it yields a tremulous or goat-sound. 

Elaterin. The active principle of the wild cucumber; a drastive 
purgative. 

Electricity. Galvanism, electro-magnetism, and animal magne- 
tism, are used for rheumatism, amaurosis, paralysis, and most 
nervous diseases. 

Element. A simple constituent or principle of the body, or any 
other substance. 

Emaciation. Wasting away. 

Emesis. Vomiting. 

Emetics. ]\Iedicines provoking vomiting. 

Emetine. The alkaloid and emetic principle of ipecac ; it is used 
as an emetic in one-grain doses. 

Emeto-Cathartic. A medicine that produces vomiting and purg- 
ing. 

Emmenagogues. Medicines believed to have the power of ex- 
citing the menses. 

Emollients. Medicines tending to soften parts that are tense and 
inflamed. 



394 GLOSSARY OF 

Empyema. Collection of pus in the pleural cavity. 

Emphysema. Cavity tilled with air; or the air may pervade the 
cellular tissue; it is divided into traumatic and idiopathic. 

Enamel. The outer surface of the tooth. 

Encysted. Covered with a sac. 

Endemic. A disease prevailing in a certain district; not epidemic. 

Endosmosis. The passage of liquids or gases through membranes. 

Endocarditis. Inflammation of the internal membrane of the 
heart. 

Endocardium. The membrane that lines the interior of the 
heart. 

Enema. Injection into the rectum. 

Engorgement. Accumulation of blood in its vessels. 

Enteric. Belonging to the intestines. 

Enteritis. Inflammation of the small intestines. 

Epidemic. A disease prevailing over an extensive country or 
district. 

Epidermis. The scarf-skin; cuticle. 

Epigastric. Above the stomach. 

Epigastrium. The region above the stomach. 

Epilepsy. Falling-sickness ; fits. 

Epistaxis. Bleeding at the nose. 

Ergot. Spurred rye. 

Erysipelas. Inflammation of the skin. 

Erythema. Simple redness. 

Euonymine. The active principle of the Euonymus Atropurpu- 
reus ; a valuable alterative, acting with great efficiency upon the 
liver. 

Eupurpurin. The active principle of the Queen of the Meadow; 
a valuable remedy for gravel and uterine diseases. 

Eupatorin (perfo). Active principle of the Eupatorium Perfoli- 
atum, or boneset ; a valuable tonic and antiperiodic. 

Euphorbin. The active principle of Bowman's root; used as an 
emetic, cathartic, and diaphoretic. 

Eustachian. A tube, leading from the throat to the internal ear. 

Exacerbation. Aggravation of fever, or other disease. 

Excretion. Anything thrown off. 

Exfoliation. A separation of dead from living bone. 

Exhalants. Vessels which throw out. 

Exosmosis is the passing of rarer fluids to the denser, through 
the membranes. 



MEDICAL TERMS. 395 

Exostosis. Morbid enlargement of the bone. 

Exotic. Belonging to a foreign country. 

Expectorant. Medicine causing a discbarge of mucus from the 
bronchi. 

Extravasation. The effusion of blood into cavities, or beneath 
the skin. 

Fascia. Tendonous expansions, covering certain muscles, &c. 

Fauces. The pharynx; back part of the mouth. 

Favus. A pustule resembling the honey-comb. 

Febrifuge. Medicine to subdue fever. 

Febrile. Belonging to fever. 

Fel Bovum. Ox-gall ; specific for quinsy. 

Felon. A deep abscess upon the finger. 

Fever. Disease characterized by three stages — cold, hot, and 
sweating stage. 

Fistula. Deep-seated ulcer, with a tube or canal opening ex- 
ternally. 

Flaccid. Soft, pliable, relaxed. 

Flatulence. Collection of gas in the stomach and bowels. 

Fluctuation. Sensation produced by percussion, when the cavity 
contains pus. 

Follicles. Folds ; as the follicles of the mucous membrane. 

Formula. Prescription for preparing medicines. 

Fremitus. A vibration felt by laying the hands upon the chest. 

Function. The action by which vital phenomena are produced. 

Functional Diseases. Those diseases in which there is supposed 
to be only derangement of action. 

Galbanum. A genus of plants, the gum of which forms a valu- 
able warming plaster for diseases of the spine. 

Gail-Bladder. A small sac connected with the liver, being the 
reservoir for the bile. 

Gangrene. Partial death of a part. 

Gastric. Belonging to the stomach. 

Gastritis. Inflammation of the stomach. 

Gaultheria. The box-berry; wintergreen. The oil is used as a 
diuretic and stimulant. 

Gland. Applied to those organs which separate from the blood 
any fluid whatever. 



396 GLOSSARY OF 

Globule. A small globe. The blood is composed of globules, the 
red, white and grey. 

Glossitis. Inflammation of the tongue. 

Glottis. A small oblong body in the larynx. 

Glycyrrhiza. Liquorice. 

Gonorrhoea. Flux from inflammation of the urethra. 

Gossypium Herbaceum. Cotton plant; the fluid extract is ex- 
tensively used as an emmenagogue. 

Gout. Inflammation of the fibrous and ligamentous parts of the 
joints. 

Gravel. Small stones in the bladder. 

H^matembsis. Vomiting of blood. 

Hematuria. Hemorrhage from the bladder. 

Haemoptysis. Hemorrhage from the lungs. 

Hemorrhage. Bleeding. 

Hemorrhoidal. Relating to hemorrhoids. 

Hemorrhoids. Piles. 

Heart. Centre of circulation. 

Hectic. A low form of an exhausting fever, characterized by in- 
termissions and remissions, and is mostly dependent upon some 
organic affection, as consumption. 

Hemiphlegia. Paralysis of one side of the body. 

Helonin. The active principle of the star-grass. 

Hepatic. Pertaining to the liver. 

Hepatization. Conversion of tissue into substance like liver. 

Hernia. Protrusion of the intestine. 

Herpes. One kind of tetter. 

Histogenic. Producing organic textures. 

Homoeopathy. Hahneman's doctrine of curing disordered actions 
in the human body, by inducing disordered action of the same kind, 
but more easily controlled. (See Homoepathy). 

Hospital. An institution for the reception and treatment of the 
sick and injured. 

Humors. All the fluids of the body except the blood. 

Hydatids. A species of encysted Entozoa. 

Hydrogogues. Medicines producing watery evacuations. 

Hydrastin. Active principle of Golden seal. 

Hydrocephalus. Dropsy of the brain. 

Hydropathy. Presnitz's method of curing disease by the external 
and internal use of water. (See Hydropathy). 



MEDICAL TERMS. 39? 

Hygiene. The science of preserving health. 
Hyosciamin. Active principle of the hen-bane. 
Hypogastrium. The lower part of the abdomen, below the um- 
bilicus, and above the pubic region. 

Hysteria. A nervous disease peculiar to females. 

Icterus. Jaundice. 

Idiopathic. Primary or original disease; one not dependent upon 
others. 

Idiosyncrasy. An individual peculiarity of constitution. 

Ignatia Amara. Plant bearing St. Ignatius' bean. 

Ileum. The longest portion of the small intestines ; also one of 
the bones of the pelvis. 

Imperforate. The congenital closure of any foramen. 

Impetigo. Moist tetter. 

Imponderables. "Without weight, as light, electricity, heat, &c. 

Incision. A clean cut by a sharp instrument. 

Incisors. The front teeth. 

Incompatibles. Medicines that cannot be used together without 
impairing their properties. 

Incontinence. The inability to retain the natural evacuations. 

Incubus. Nightmare. 

Indication. That which demonstrates what ought to be done. 

Indigenous. That which is peculiar to a country. 

Indigestion. Dyspepsia. 

Indolent Ulcers. Those which do not incline to heal. 

Induration. Hardness of a tissue. 

Infectious. Communicable. 

Infiltration. Extravasation of blood or other fluids into the soft 
tissues. 

Infinitesimal. Inconceivably minute. (See Homoeopathy). 

Inflammation. A state in which the capillaries of the affected 
parts are interrupted in their proper function, are morbidly relaxed 
and over distended, and in which the blood which is passing through 
them is first abnormally excited and chemically changed, and then 
stagnates and coagulates. (Calvin Newton). 

Inflammatory. That which relates to inflammation. 

Iufluenza. Epidemic catarrh or cold. 

Infusion. Watery decoction. 

Ingestia. Food or drink. 
34 



398 GLOSSARY OF 

Inhalation. The act of inspiration; also the method of curing 
disease by inhaling vapors. 

Injection. Clyster; enema. 

Innoculation. The insertion of morbific matter into any part of 
the system. 

Inorganic. Not organized. 

Insane. An unsound mind or intellect. 

Insanity. A deviation from the natural manifestations of mind. 

Inspiration. The act of receiving air into the lungs. 

Integument. That which covers anything ; as the skin, &c. 

Intermission. The intervening time between the paroxysms of 
periodical diseases. 

Intermittent Fever. (See Fever and Ague.) 

Invagination. A portion of the intestines, falling into one an- 
other, becoming strangulated. 

Iodine. Elementary body obtained from sea-weed. 

Iodide of Potassium. Compound of iodine and potassium. 

Irisin. The active principle of blue-flag. 

Iritis. Inflammation of the pupil of the eye. 

Irritability. A contractility of the solids, when stimulants are 
applied. 

Irritation. The effect of stimulants. 

Jalap. A purgative root. 
Jalapin. The active principle of the jalap. 
Jaundice. A disease accompanied with yellowness. 
Juglandin. The active principle of the butternut. 

Kings'-Evil. Scrofula. 

Kinesopathy. Method of curing disease by rubbing. 
Kaino Miasmata. Malaria; exhalation from putrifying sub- 
stances. 

Labia. Lip. 

Lactine. Sugar of milk. 

Languor. Debility. 

Laryngeal. Belonging to the larynx. 

Laryngitis. Inflammation of the larynx. 

Larynx. The upper part of the windpipe. 

Laxative. A mild purgative. 

Leech. An aquatic worm. 



MEDICAL TERMS. 399 

Leptandrin. A valuable alterative obtained from the black-root. 

Lethargy. Continued sleep or stupor ; coma. 

Leucorrhcea. Sexual weakness, peculiar to females. 

Litmus Paper. Used for detecting acids and alkalies. 

Lobelia-Inflata. Indian tobacco. 

Lobelin. The active principle of lobelia, which is extensively 
used as a medicine. 

Lumbago. Rheumatic affection of the back. 

Lumbrici. Round worm of the intestines. 

Lupulin. One of the active principles of the hop ; used in ague 
and nervous diseases. 

Lymph. A thin, transparent fluid, which circulates in the lym- 
phatics. 

Lymphatics. Vessels carrying lymph. 

Maceration. Softening in water. 

Magnesia, Sulphas. Epsom Salts. 

Magnesia. One of the earths, having a metallic basis. 

Malaria. Supposed to be a noxious gas, arising from decomposi- 
tion of vegetable matter. 

Malformation. Defective, irregular. 

Marshmallow. A valuable mucilaginous diuretic. 

Matico. A styptic plant ; native of Mexico. 

Measles. An eruptive fever. 

Meatus. A passage. 

Melasna. Discharge of dark blood from the bowels. 

Melancholy. Species of deranged mental action. 

Melanosis. Black deposits of a tuberculous character. 

Meningitis. Inflammation of the membranes of the brain. 

Meningial. Relating to the membranes of the brain. 

Menorrhagia. Excessive menstruation. 

Menstruation. The catamenia. 

Mercurial. Pertaining to mercury. 

Mercury. Quicksilver. Hydrargyrum. 

Mesmerism. Somnambulism ; first produced by Mesmer. 

Metamorphosis. Transformation. 

Metastasis. Change in the seat of the disease. 

Metritis. Inflammation of the womb. 

Miasm. Poisonous emanation from decomposing vegetable and 
animal substances. 

Miliary Fever. Name given to eruptive fever in children. 



400 GLOSSARY OF 

Mollities Ossium. Softening of the bones. 
Morbific. , Causing diseases. 
Morbus Coxarius. Hip-disease. 
Mortification. Death of a part. 
Mucilage. A watery solution of gum. 
Mucus. Animal Mucilage. 

Murmurs, Respiratory. Are the sounds produced by the air 
passing in and out of the lungs. 

Myricin. The alkaloid of the bayberry. 

Narcotic. Remedy producing sleep or stupor. 
Nausea. Sickness at the stomach. 
Necrosis. Death of a bone. 

Nerves. Small cords conveying sensation to different parts of the 
system. 

Nervine. Medicine allaying nervous excitement. 

Neuralgia. Pain in the nerves. 

Nitre. Saltpetre. 

Nitro-muriatic Acid. Used as a styptic. 

Nutrition. Increase, growth. 

Nymphsea Odorata. White pond lily. 

Occult. Hidden, latent. 

(Edema. Effusion into the cellular membrane. 

(Esophagus. Passage leading from the back part of the mouth to 
the stomach. 

Olfactory. Relating to the sense of smell. 

Ophthalmia. Inflammation of the eyes. 

Opium. The concrete juice of the poppy. 

Optic. Relating to the eye. 

Organs. Parts performing a definite function. 

Organic Diseases. In Pathology, diseases in which there is 
derangement or alteration of structure, are termed organic. 

Orthopnoea. Difficult respiration, requiring the erect posture. 

Os. A bone. 

Osseous. Bony. 

Ostitis. Inflammation of the bone. 

Otitis. Inflammation of the ear. 

Otorrhcea. A purulent discharge from the ear. 

Ovaries. Two small oval* bodies attached to the uterus, one on 
each side. 



MEDICAL TERMS. 401 

Ovum. An egg. 

Oxygen. One of the most extensively diffused elements in nature. 

Ozaena. A fetid ulcer in the nose. 

Painters' Colic. A dangerous kind of colic, ascribed to absorp- 
tion of lead. 

Palate. The roof of the mouth. 

Palpation. The method of examining the chest by application of 
the hand. 

Palpitation. An increased and irregular action of the heart. 

Panacea. A remedy used for all diseases. 

Pancreas. The gland situated behind the stomach. 

Pancreatic Juice, The secretions of the pancreas. 

Paralysis. Loss of motion. 

Paraplegia. Paralysis of the lower half of the body. 

Parenchyma. The cellular tissue ; the principal part of an organ. 

Pathognomonic. Characteristics of disease. 

Pathological. Morbid changes. 

Pathology. Doctrine of disease. 

Pediluvian. Foot-bath. 

Pemphigus. Eruptive disease, characterized by small blisters. 

Periostitis. Inflammation of the periosteum. 

Peritoneum. Serous membrane lining the abdomen. 

Pertussis. Hooping-cough. 

Pharmacy. The art of preparing and combining medicines. 

Pharyngitis. Inflammation of the pharynx. 

Pharynx. Back part of the mouth. 

Phlebitis. Inflammation of the veins. 

Phlogistic. Inflammatory. 

Phrenitis. Inflammation of the brain. 

Phthisis. Consumption. 

Physiology. Science of life. 

Phytolaccin. A concentrated remedy prepared from the poke- 
root, a valuable alterative. 

Piles. Varicose veins appearing about the anus. 

Piperin. A concentrated remedy prepared from the black pepper. 

Plethora. Over-distension of the blood-vessels. 

Pleura. A serous membrane lining the chest. 

Pleuritis. Inflammation of the pleura. 

Pneumonia. Inflammation of the lungs. 
34* 



402 GLOSSARY OF 

Podophyllin. A concentrated remedy prepared from the man- 
drake. 

Poison. That substance which, when taken into the system, 
produces disease, rapidly tending to dissolution. 

Polypus. A tumor growing in the cavities of the body. 

Populin. Concentrated remedy prepared from the poplar. 

Precordia. The fore part of the thorax. 

Probang. An instrument used to apply caustics to the throat. 

Prunin. Concentrated remedy prepared from the wild cherry. 

Pulmonary. Belonging to the lungs. 

Pulsatilla. The anemone pratense. 

Pulse. Beating of the heart an$ arteries. 

Purgatives. Medicines which increase the peristaltic motions of 
the bowels. 

Purpura. Scurvy. 

Purulent. Besembling pus. 

Pus. Matter produced by suppuration. 

Quack; Quac.ksalber. An ignorant physician. 

Quack' Medicines. Secret remedies administered by quacks. 

Quassia. A bitter wood ; used as a tonic. 

Quicksilver. Mercury. 

Quinine. Alkaloid of Peruvian bark. 

Quinsy. Inflammation of the tonsils. 

Bash. Patches of redness on the skin. 

Begurgitation. Beturn of blood, as from the ventricle of the 
heart to the auricle. 

Begimen. Begulation of diet, so as to promote health. 

Bemission. Time between paroxysms of ague. 

Besonance. A revibration of sound. 

Bespiration. Breathing. 

Bheum Palmatum. Bhubarb. 

Bheumatism. Inflammation of the membranes of the joints. 

Boseola. Bose-rash. 

Bubeola. Measles. 

Salicin. Concentrated remedy, prepared from the willow. 
Sanguinarin. Concentrated remedy, prepared from Bloodroot. 
Santonine. A crystalline body, obtained from worm seed. 
Scarlatina. Eruptive fever. 



MEDICAL TERMS. 403 

Schirrous. Hard. 

Scorbutus. Scurvy. 

Scrofula. A chrome disease of the lymphatic system. 

Scutellaria Concentrated remedy, prepared from the skull-cap. 

Sedative. A remedy that lessens arterial and nervous excite- 
ment. 

Senecin. Concentrated remedy, prepared from the Senecio gra- 
cilis. 

Serous. Watery. 

Sialagogue. Medicines that increase the flow of saliva. 

Sibilant. A hissing sound heard in disease of the lungs. 

Sinapism. Mustard-poultice. 

Solidist. One who ascribes all diseases to the solids. 

Somnambulism. Sleep-walking. 

Spasm. Morbid contraction of the muscles, cramp, &c. 

Specific. A remedy competent to remove the disease. 

Spermatorrhoea. A seminal weakness. 

Spleen. An organ found on the left of the stomach. 

Stethoscope. An instrument employed for examining diseases 
of the chest. 

Stillingia Sylvatica. Queen's root. 

Stomacace. Canker of the mouth. 

Stomatitis. Inflammation of the mouth. 

Strangury. Painful discharge of the urine. 

Strumous. Scrofulous. 

Sudorific. Producing perspiration. 

Suppuration. Formation of pus. 

Syncope. Fainting. 

Syphilis. Venereal disease. 

Systole. Contraction of the heart. 

Tannic Acid. Astringent property of oak bark. 
Tartar Emetic. Tartarized antimony. 

Tenesmus. A griping in the lower portion of the bowels, and 
constant desire to go to stool. 

Turpentine. Concrete juice and oil from pine. 
Thorax. The chest. 
Thrush. White ulcers in the mouth. 
Tinnitus Aurium. Drumming in the ears. 
Tolu. Balsam extracted from a species of fir. 
Tormina. Griping pain in the bowels. 



404 GLOSSARY OF MEDICAL TERMS. 

Trachea. Windpipe. 

Tracheitis. Inflammation of the mucous membrane of the trachea. 
Tubercles. Applied to scrofulous tumors. 
Tuberculous Phthisis. Scrofulous affection of the lungs. 
Tumid. Distended. 
Tympanitis. Abdominal distension. 
Tympanum. Drum of the ear. 

Typhoid Fever. Fever, in which the disease is principally located 
in the bowels. 

Ulcer. A morbid solution of the continuity of the part. 
Umbilicus. Navel. 

Urea. Cyanate of ammonia ; a constituent of the urine. 
Urethra. Canal from the bladder, for the passage of the urine. 
Uriscopist. Quack doctor, who pretends to form diagnosis of 
disease from the urine. 

Vaccination. Insertion of cow-pox virus, as a protection against 
small-pox. 

Valerian. Root used as a nervine. 

Variola. Small-pox. 

Varioloid. Modified small-pox. 

Vascular. Belonging to vessels. 

Venesection. Bleeding from a vein. 

Veratrum Viride. A valuable remedy for fevers. 

Veratrin. Concentrated principle of the veratrum. 

Vermifuge. Medicine given for worms. 

Vertigo. Dizziness. 

Vesicle. Bladder of water. 

Viburine. Concentrated remedy, prepared from the high cran- 
berry. 

Vital. Connected with life. 

Vomica. An abscess in the lungs. 

White Swelling. An inflammation of the periosteum and dis- 
ease of the bone. 

Xanthoxylin. Active principle of the xanthoxylum fraxineum, 
or prickly ash. 

Zimotic. Contagious. 

Zinc Sulphas. Styptic salt, and mild caustic. 



APPENDIX, 



CONTAINING 

AN OUTLINE OF ECLECTIC PHARMACY AND 
MEDICAL PREPARATIONS, TO BE USED IN 
DOMESTIC PRACTICE. 

Every family should obtain a case of concentrated medicines, in 
order to make their own prescriptions when medical aid is indicated, 
unless the nature of the case is such that it can only be understood 
by a physician well versed in his profession. The non-professional 
individual, before attempting to prescribe for a patient, should care- 
fully observe all the symptoms present, and as carefully compare 
them with those described in this work, or by other reliable authors ; 
for unless the indications to be fulfilled are fully understood, it is 
far better to leave the disease to the unaided efforts of nature, than 
to attempt medical interference, bearing in mind that unskilful 
medication always lessens the chances of recovery. The next duty 
is to fully understand the properties of -the remedy to be used, and 
its preparation for administration. In the use of the concentrated 
remedies described in this work, they should be triturated with 
sugar, by adding ten grains of the article to be used to one hundred 
of pure white sugar. Place both in a wedge-wood mortar, and tritu- 
rate for thirty or forty minutes, or until every particle of the medi- 
cine is thoroughly incorporated with the sugar. The doses recom- 
mended in this work mostly have reference to the triturated article. 
It will be noticed, that where the medicine is thus prepared, a much 
less quantity is required than when given in a crude state ; besides, 
when the articles are taken into the stomach in a crude state, they 
produce local irritation, frequently causing rejection, or producing 
constitutional symptoms, which very much lessen their curative 
powers. 

The quantity to be administered must depend altogether upon the 
age, temperament, constitution, &c. of the patient. For the pro- 
portionate doses of different ages, the reader is referred to the table 

(405) 



406 APPENDIX. 

of doses, as modified by age, in another part of this work. The 
time required for an ordinary dose of triturated medicine to pass 
into the circulation is from one to two hours ; consequently, if the 
first dose is not sufficient to accomplish the object for which it was 
given, it may be repeated every one or two hours until the desired 
effect is produced. Pure soft water is the best material in which to 
mix the medicine for administration; all jams and jellies should be 
carefully avoided, as they frequently entirely neutralize the medi- 
cinal properties of the article. If the medicine is a tincture, as 
aconite or vei'atrum, it may be largely diluted in soft water, as one 
half dram ofthe tincture may be added to one half tumbler of water, 
and one tablespoonful given every fifteen or twenty minutes until 
the requisite quantity has been taken. All the tinctures may be 
taken in this way. In acute diseases, but one kind should be given 
at once, unless there is a marked indication for some other remedy 
which is compatible with the one being taken ; or, unless the medi- 
cines possess the same properties, and one be mixed with the other 
to modify its action ; as quinine and cornin, both being antiperiodics, 
when combined, one facilitates the action of the other ; so with many 
other remedies. But, in domestic practice, unless the prescriptions 
are followed as laid down in connection with each separate disease, 
the remedies had better be used one at a time. The best method of 
using crude articles of medicine is in the form of an infusion or 
syrup. 

To make an infusion of any article of medicine. Take one pint 
of warm or cold water, for one ounce of the remedy, much care 
being taken to prevent boiling or overheating, as this frequently 
destroys the virtue of the remedy. 

Syrup. 

In chronic diseases, syrup is often the best form of administering 
medicine, as much benefit is derived from the sugar it contains ; 
frequently the sugar is more beneficial than the medicine. 

Sugar serves the purpose of combustion in the lungs and extreme 
capillaries, thereby increasing the animal temperature, promoting 
secretion, excretion, &c. It is stated, upon good authority, that 
the negroes on the sugar plantations become very fat and free from 
disease during sugar boiling. And, as I have already stated, in the 
treatment of Consumption, sugar is of great value. The best method 
of preparing syrup for domestic practice is to add one pound to one 
pint of strong infusion. 



APPENDIX. 407 

Tinctures. 
The method of preparing tinctures for domestic practice is to 
add two ounces of the green vegetable to one pint of good pure 
whiskey, and let it stand fourteen days, "when it should be strained 
and bottled for use. 

Pills. 

The most uncertain method of using medicines is in the form of 
pills, as they frequently become dry and hard, requiring a long time 
to digest; they also frequently lose their strength by standing. Yet 
it is sometimes advisable to use some of the extracts in the form of 
a pill. They may be made by rolling in pure starch or pulverized 
liquorice, and only as fast as used. 

Purgatives. 

Purgative medicines are those which increase the alvine evacua- 
tions, or increase the peristaltic action of the bowels. This class of 
medicines, although of great service in many diseases, is also capa- 
ble of producing very bad effects. 

The constant use of purgative medicines has a tendency to irritate 
and derange the action of the bowels. They are mostly useful in 
case of obstinate constipation ; in most brain affections ; in inflam- 
mation of the peritoneum ; and in some other diseases ; but in 
typhoid fever, inflammation of the stomach and bowels, and in all 
cases of great debility they are utterly inadmissible. Among the 
best purgatives, are Euonymine, Podophyllin, Iridin, Neutralizing 
Cordial, and Anti-bilious Physic. 

Emetics. 

Emetics are those remedies which evacuate the stomach. They 
are serviceable in the commencement of many fevers, also in some 
chronic diseases, and always when the stomach is loaded with some 
foreign substance. The best medicines for emetics are Lobelia, 
Blood-root, and Ipecac. 

Before administering an emetic, the patient should drink a mode- 
rate quantity of some warm tea, as chamomile, catnip, ginger, or 
Thomson's composition. If lobelia is given, from one half to one 
teaspoonful of the tincture may be taken every five or ten minutes, 
until it operates as desired. The tincture of blood-root and ipecac 
may be used in larger quantities, say in teaspoonful doses. The 
pulverized seed of lobelia may be given, by adding one half tea- 



408 APPENDIX. 

spoonful to one teacupful of warm water, and, after steeping ten or 
fifteen minutes, one tablespoonful may be taken every ten minutes 
until the desired effect is produced. Thirty grains of pulverized 
ipecac, and sixty grains of pulverized blood-root may be used in 
the same way. 

Diuretics. 

Diuretics increase the secretion and flow of urine. These remedies 
are often of great value in the treatment of disease. They operate 
with the greatest efficiency when largely diluted with warm water* 
and the surface is kept cool. Among the best diuretics are Marsh- 
mallow, Clivers, Indian Hemp, Queen of the Meadow, and Dwarf 
Elder. 

Diaphoretics. 

These are medicines which lessen the heat, by increasing the 
moisture of the surface of the body. They are serviceable in all 
cases of fevers. Aconite and Veratrum are among the best diapho- 
retics. 

Expectorants. 

Expectorants increase the discharge from the mucous membrane 
of the bronchi and lungs. They are valuable in some cases of acute 
and chronic affection of these -organs. But in all cases of true 
phthisis they are very injurious. Among the best expectorants are 
Lobelin, Sanguinarin, and Eupatorin. 



uisms, or Mustard Poultices. 
These are prepared by adding one tablespoonful of mustard to three 
of flour, mixing with equal parts of vinegar and water. They are 
beneficially used to attract the blood from the deep-seated to the 
superficial capillaries. They are also applied to the spine and nape 
of the neck in inflammation of the brain. 

Cataplasms, or Poultices, 

May be made by moistening bread-crumbs with milk. They may 
also be made of flaxseed. Roasted onions, snake-root, &c, may be 
used for poultices. They are useful in nearly all cases of local 
inflammations. 

Clysters, or Injections. 

When these are used merely to act upon the bowels, warm water 
or flaxseed water may be used. Any medicine may be thus admin- 
istered when the stomach will not tolerate them. 



APPENDIX. '409 

Fomentations. 
Cloths wrung out of hot water, or an infusion of any medicinal 
substance, are applied for local congestion or inflammation. In 
these applications, the adjacent clothing should be protected from 

moisture by oil-silk. 

Plasters. 

These are made by compounding medicines with gums, resins, &c. 

The Irritating Plaster. 
This is made by using boiled tar, one pound ; Burgundy pitch, 
one-half ounce ; "White gum turpentine, one ounce ; Rosin, two 
ounces. Melt the tar, rosin, and gum, together, remove from the 
fire, and add finely pulverized mandrake root, bloodroot, pokeroot, 
indian turnip, each one ounce. This plaster is used extensively in 
all cases where counter-irritation and revulsives are indicated; as 
in rheumatism, neuralgia, and chronic affections of the liver and lungs. 
By Eclectic physicians, this is used in many cases where blisters are 
used by the "old school," and experience has shown it to be far 
superior. 

Adhesive or Strengthening Plaster. 

Take of Rosin, one pound; Beeswax, one ounce; Burgundy 
Pitch, one ounce ; Mutton Tallow, one ounce. Melt them together, 
and add, Olive Oil, Pulverized Camphor, and Sassafras Oil, of each 
one-sixth of an ounce ; West India Rum, one fluid ounce. Stir well 
together, pour into cold water, and form it into rolls with the hands. 
This is an excellent plaster in weakness of the joints, rheumatism, 
weak back, weak chest, ulcers, &c. 

Ointments. 
An ointment for the cure of burns may be made as follows : take 
fresh butter, one.-half pound ; Yellow Dock root, cut in small pieces, 
one ounce ; fresh Raspberry leaves, one-half ounce ; White Wax, 
one ounce. Melt the butter and wax together, add the Raspberry 
leaves and Dock root, simmer fifteen or twenty minutes, and strain 
while warm. This is an excellent ointment for burns and scalds. 

Domestic Treatment for Diseases of Common Occurrence. 
For Burns and Scalds, wrap the part immediately in cloths, wet 
in cold water ; change as often as necessary to keep them cool ; apply 
until the pain entirely ceases. After which, spread the ointment, 
35 



410 APPENDIX. 

for burns and scalds, upon apiece of cloth, and apply to the abraded 
surface. Change and wash as often as indicated. If the patient is 
drowsy or sleepy after the burn, a stimulating cordial should be 
given ; as a little whiskey-sling, or tincture of capsicum. 

Convulsions in Children. 
The feet should be placed immediately in warm water, a weak 
mustard poultice applied to the stomach, friction to the spine, a 
cold cloth to the head, and give from five to ten drops of the tinc- 
ture of lobelia, until relieved. If the child is unable to swallow, 
the lobelia should be mixed with starch-water, and given as an in- 
jection. Unless relief is immediately effected, place the child in a 
warm bath. As soon as the convulsion is relieved, the cause should 
be ascertained and removed ; as otherwise, it might assume an 
epileptic character. 

For Children troubled with Worms. 
Take ten grains of Santonine, and one hundred grains of sugar, 
triturate well together. For a child five years old, one tenth of it 
is a dose every other night on going to bed. If the worms are not 
expelled, continue this until the whole is taken. If the child has 
fever, one or two drops of the Tincture of Aconite may be given 
two or three times a day. If the worms are not expelled when the 
medicine is all given, a mild purge may be administered. This 
seldom fails to remove worms from the alimentary canal in any 

case. 

For Files in Children or Adults. 

A few drops of the oil of fire-weed, made into an ointment, with 
fresh butter, and applied externally. Take also, one or two drops 
of the oil internally, once or twice a day. This will effect a cure. 

Tooth-ache. 

Take two grains of the extract of Belladonna ; one grain of the 
extract of Cicuta ; one-half ounce of Chloroform. Dissolve the 
extracts in the chloroform, wet a little lint, and apply to the tooth. 
This affords instant relief. 

For Diarrhoea. 

The most valuable remedy for this, is the neutralizing cordial, 
which no family should be without. It is made as follows: One 
half pound of rhubarb ; of cinnamon and cloves, each one-fourth 
of a pound ; peppermint and saleratus, each one-half pound. Add 



APPENDIX. 411 

to one gallou of water. Steep for one-half hour. Strain, add two 
pounds of white sugar. Simmer fifteen minutes ; when cool, add 
one pint of brandy, and bottle for use. Dose for children, one tea- 
spoonful ; for adults, one tablespoonful. 

Chilblains. 
The best method for curing chilblains, is to bathe them in warm 
turpentine, once or twice a day, wearing cotton next the feet. 

Warts. 
For their removal, rub every day with the juice of garden parsley. 

For Bites of Insects. 
Bathe with the tincture of pennyroyal. This gives immediate 

relief. 

Chronic Dyspepsia. 

Drink freely of cold water, with a little salt in it, every morning 
on rising. This, and the avoidance of strong medicine, will gene- 
rally give relief. 

Croup. ■ 

Syrup of Bloodroot, as directed in another part of this work, is 
a sure remedy. 

Flatulency, or Wind- Colic in Children. 

Give one or two drops of equal parts of Gelseminum and pepper- 
mint essence, which will afford immediate, relief. 

Sore Nipples. 
Bathe in strong infusion of bayberry bark, two or three times a 
day ; and wash well with soap and water after nursing, 

Food and Drink for the Sick. 

The best drink is pure cold water, which should be allowed under 
all ordinary circumstances, in liberal quantities. 

Frequently, but little food is demanded in acute diseases. When 
it is given, it should be in the form of broths, gruel, &c. Beef- tea, 
prepared as under the head of typhoid fever, is an excellent article, 
and may be given in all cases of fever where food is required. 
Bread, water, rice-water, rice, coffee, &c, may also be given. 
Those who have charge of the sick, should carefully avoid urging 
them to take food against their inclination, as much mischief may 
be done, by crowding the stomach with food which it is not able to 
digest. 



412 APPENDIX. 

Ventilation. 
The apartment of the sick should be thoroughly ventilated, by 
allowing a free circulation of fresh air to pass through the room, in 
such a manner as not to come directly in contact with the head of 
the patient. All the excretions from the bowels and bladder should 
be removed immediately, and the room purified, by a free ingress 
of fresh air, instead of still further vitiating it by fumes of vinegar, 
sugar, &c. 

Bathing the Sick. 

In all cases of acute disease, the surface should be thoroughly 
bathed, as often as once or twice a day. The sick room should be 
always kept quiet, and the linen of the bed and person changed 
every twenty-four hours. 



32* 



ALPHABETICAL INDEX. 



PAGE 

Abbreviations, explanation of. 384 

Ague and fever 50 

Allopathic treatment 324 

Amaurosis 235 

Anasarca 174 

Angina Pectoris 207 

Anti-bilious Physic , 323 

Anti-scrofulous Syrup 318 

Apoplexy 17S 

Appendix 405 

Ascaris* lumbricoides 187 

vermicularis 187 

Ascites 174 

Asiatic Cholera 162 

Asthma 159 

Atrophy of the heart 212 

Blue skin disease 219 

Brain, dropsy of 172 

" hemorrhage of. 178 

u inflammation of 74 

Bronchitis . 152 

Bronchitis drops.. 322 

Cardialgia 204 

Carditis 212 

Cephalalgia 220 

Chicken Pox..., 167 

Chlorosis 189 

Cholera Asphyxia 162 

Morbus 161 

" Sporadic 162 

Chorea 179 

Cbrono-thermal system 361 

Colic. Lead, or Painters' 90 

" spasmodic 89 

Colitis 83 

Congestion, uterine 254 

Conjunctivitis 232 

Consumption 113 

Convulsions 221 

Cough, Hooping 94 

Croup. Pseudo-membranous 185 

; - Spasmodic 1S5 

Cyanosis 219 

Cynanche Maligna 91 

; * parotidea 175 

" tonsillaris 78 

Cynanche trachealis 185 

Cystitis 157 

Delirium tremens 171 

Diabetes Mellitus 182 

Diagnostic signs 286 

Different systems of practice 324 

Diseases of the heart 204 

35* 



PAGE 

Diseases of the skin 237 

Dentition, difficult 194 

Dilitation of the heart 215 

Doses, proportionate 384 

Dropsy of the abdomen 174 

" * brain 172 

" general 174 

Dysentery 83 

Dyspepsia 81 

Eclectic remedies 295 

" " their preparation... 383 

Eczema 239 

Emphyema 107 

Emphysema 155 

Encephalitis 74 

Endocarditis 211 

Enteritis 82 

Enuresis 250 

Epilepsy 176 

Erysipelas 95 

Erythema 277 

Exanthemata 167 

Fever, ephemeral 49 

intermittent.- 50 

miliary 190 

pathology of 362 

remittent 53 

scarlet 57 

typhoid.. 62 

typhus 57 

yellow 69 

Fistula in ano 276 

Gastritis.. ,. 80 

Gastrodynia 199 

Glossary of medical terms 385 

Haematemesis 200 

Hematuria 251 

Haemoptysis 149 

Headache 220 

Heart disease 209 

" burn 204 

Hemiplegia 179 

Homoeopathic Treatment 339 

Hemorrhage, cerebral 178 

gastric 200 

pulmonary 149 

Hemorrhoids 274 

Hepatitis 1S8 

■Herpes circinatus 238 

" zoster 237 

Hooping Cough 94 

Hydrocephalus. 172 

(413) 



414 



INDEX. 



Hydropathic Treatment 353 

Hydrophobia 181 

Hypertrophy of the heart 213 

Hypochondriasis 229 

Hysteria 221 

Icterus 202 

Incontinence of urine 250 

Inflammation 72 

" of the bladder 157 

" " brain 74 

" " colon 83 

" " conjunctiva 232 

" " ear 79 

" " intestines 82 

" " kidneys 156 

" " liver 158 

« " lungs 87 

" " oesophagus 198 

" " parotid 175 

" " pericardium 209 

" ''• peritoneum 86 

" « pleura 97 

" " stomach 80 

" " thorax 97 

" " tonsils 78 

" " trachea 185 

" " veins 216 

Ischuria 248 

Itch, or Scabies 240 

Jaundice 202 

Lead colic 90 

List of Eclectic remedies , 295 

Liver, inflammation of. 158 

Lock-jaw 181 

Mania-potu 171 

Measles , 169 

Medical terms 385 

Meningitis 74 

Menses, cessation of 260 

Mercurial disease... 277 

Metritis 254 

Morbus Cseruleus 219 

Mothers' Cordial 317 

Mumps 175 

Myolitis 226 

Nephralgia 223 

Nephritis 156 

Nettle rash 192 

Neuralgia 223 

(Esophagitis. 198 

Ophthalmia, catarrhal 232 

" purulent 234 

Otitis 79 

Ovarian disease 262 

Palpitation of the heart 205 

Paracentesis Ill 

Paralysis 179 

Paraplegia , 179 

Parotitis 175 



PAGE 

Peritonitis 86 

Pertussis 94 

Phlebitis 216 

Phlegmasia Dolens c 216 

Phrenitis 74 

Phthisis ;.... 113 

Piles.. 



274 

Plague 195 

Pleurisy , 97 

Pneumonia 87 

" typhoid 87 

Preparation of Eclectic remedies 383 

Pulmonary Balsam 322 

Purpura hemorrhagica 243 

Pustulge 241 



Pericarditis 209 Worms 



Quinsy 78 

Rabies canina 181 

Retention of urine 248 

Rheumatism 184 

Roseola a... 192 

Rubeola 169 

Salt rheum 237 

Scabies 240 

Scarlatina 91 

Scrofula 264 

Scurvy 243 

Small-pox 167 

Spasmodic croup 185 

Spasms 221 

Spinal irritation 227 

Spitting of blood 149 

Stomatitis 77 

St.Vitus' dance 179 

Suppression of urine 248 

Syrup of Alum 322 

" " Marshmallow -320 

" " Stillingia 319 

" " {i compound 321 

Table of doses 384 

" " Homoeopathic dilutions 352 

Taenia , 187 

Tetanus 181 

Thoracic disease 87 

Thrush 76 

Tic Douloureux 223 

Tonsillitis 78 

Tracheitis 185 

Trismus ; 181 

Typhoid fever 62 

" pneumonia 87 

Urine, bloody 251 

" diabetic 182 

" incontinence of. 250 

" retention of 250 

Urticaria ,. 192 

Uterine congestion 254 

Varicella... 167 

Variola 167 

Worm mixture 323 



187 



ECLECTIC MEDICAL COLLEGE OF PENNSYLVANIA, 

LOCATED IN PHILADELPHIA. 



Sessions commence on the second Wednesday in October, and close about the first of 
February following. 

FACULTY OF MEDICINE. 

Joseph Sites, M. D., Professor of Obstetrics and Diseases of Women and Children. 

Henry Hollembaex, M.D., Professor of Materia Medica and Therapeutics. 

Thomas G. Chase, M.D., Professor of Chemistry and Medical Jurisprudence. 

Wm. Paine, 31. D., Professor of the Theory and Practice of Medicine and Pathology. 

Marshall Calkins, M. D., Professor of the Institutes and Practice of Surgery. 

J. B. Holland. M.D., Professor of Anatomy and Physiology. 

Marshall Calkins. M. D., Demonstrator of Anatomy. 

Marshall Calkins. M.D., Dean of the Faculty, Xo. 913 Race Street, Philadelphia. 

This Institution (the only chartered one of the kind in this section of the country) 
teaches the Eclectic System of Medical Practice. The advocates of this system 
contend that no one system of medical practice, separately considered, is, in itself, 
perfect; that in each there is much that is good, while there is more or less of im- 
perfection ; "being to some extent either defective in efficiency, or exerting, in connec- 
tion with their beneficial action, an influence which has proved, in many instances, 
positively injurious. 

"While, therefore, they would not rely upon any one system of practice, so as to 
use it altogether to the exclusion of every other, they would, with wise discrimi- 
nation, separate whatever is truly good in each from all that it contains which is 
useless or injurious; leaving it to each individual to make his choice as to the par- 
ticular system or systems which he may prefer, using them separately or in combi- 
nation, as his own judgment may dictate; keeping in view, however, the grand and 
important idea that he is to select what will be most efficient, and discard what is 
hurtful; always endeavoring, in the choice and application of remedial processes 
and agents, to select such as shall not injure the constitution, or entail upon the 
system secondary diseases, which may be far more serious than those which they 
were originally given to overcome. Blood-letting, Mercurializing, &c, are, there- 
fore discarded, and such remedies and applications are made choice of as tend to 
correct disordered action and augment the vital energy, thus enabling the body 
which is disease! to throw off the load under which it is laboring. 

The principles which characterize Eclecticism, are such as appeal to the common 
sense and reason of mankind; it is not surprising, therefore, that it is becoming 
more prized as it becomes better known, and that large accessions are making to 
the ranks of its advocates, out of all the different systems of medical practice of 
the day. Even Homoeopathy and Hydropathy are contributing largely to swell 



416 ECLECTIC MEDICAL COLLEGE 

the numbers of those who believe in the correctness of the theory which it pro- 
mulgates, and the superior efficacy of the method of treatment which it sanctions. 

The Eclectic Medical College of Pennsylvania was chartered by the State Legis- 
lature in 1850, and is endowed with all the powers and privileges which are pos- 
sessed by institutions of a similar character. It possesses a Museum which is valu- 
able, and sufficiently ample for the illustration of the subject of disease and the 
structure of the human system. 

Concerning the Faculty, the Philadelphia Sunday Mercury, of March 1st, 1857, 
comments freely: — 

" Characteristics of the Faculty of the Eclectic Medical College. 

"Dr. Sites is a graduate of the Syracuse Medical College, and a man who has, by 
perseverance in study and practice, become one of the most successful teachers of a 
difficult hranch of the profession. He is decidedly original and independent in his 
views, giving little heed to precedent or mere book authority. He has now in 
manuscript, a Treatise on the American Eclectic Practice of Obstetrics, the publi- 
cation of which the liberal physicians of this country are anxiously awaiting. In 
his lectures, he is very impressive, driving his ideas, as if by force, into the minds 
of his pupils. Everything connected with his department is fully and completely 
illustrated. A large number of choice obstetric preparations in the College are due 
to his energy and generosity. 

" Dr. Hollembaek is a graduate of the Pennsylvania Medical College, and has, like 
Dr. Sites, devoted himself assiduously to the interests of the Eclectic Medical 
College. In his lectures, he devotes much time to the consideration of the various 
remedial agents of different sects, explaining their proper and improper uses and 
applications. 

"Dr. Hollembaek has now in course of preparation a work on Materia Medica, 
the completion of which the profession are anxiously awaiting. He is an interesting 
and agreeable lecturer, and is highly respected by the Eclectic Profession in this 
section of the country. 

"Dr. T. G. Chase is a graduate of Harvard University, both in Arts and Medicine, 
and, in 1821, visited Europe for the purpose of obtaining more extensive informa- 
tion. He is a man of great scientific attainments, and has labored much for the 
interests of the College, with which he is now connected. 

" Dr. Chase is a good lecturer on Chemist^, and appears to be an agreeable gentle- 
man. Our personal knowledge of him being limited, we are unable to present his 
antecedents and social qualities, although he stands in high estimation in his circle 
of friends and acquaintances. 

"Dr. Calkins received the degrees of A. B. and A.M. at Union College, and, at the 
Worcester Medical Institution, the degree of M. D. He was a pupil of the late, 
learned, eminent and lamented Dr. Calvin Newton, who, at the time of his decease, 
had in course of preparation a work on Thoracic Diseases, wbich was completed 
by Dr. Calkins. It has had a rapid sale, and meets the wauts and approval of liberal- 
minded physicians on both sides of the Atlantic. We have in our possession a copy 
of this work, and consider it the most original, lucid, and satisfactory work on 
Consumption, and kindred diseases, we have ever perused. Dr. Calkins has much 
experience as a teacher, both in literary and medical institutions, and has contri- 
buted many valuable pages to the liberal medical journals of the country. He is 
a concise and pleasing lecturer, always endeavoring, as much as possible, to deduce 
from the teachings of Physiology those scientific principles which are a sure and 
unerring guide to all successful medication. He is an affable and entertaining 



OF PENNSYLVANIA. 417 

gentleman, and .uighly appreciated for his scientific accomplishments and Lis ex- 
cellent moral and social qualities. 

" Dr. Paine received a medical education at the Berkshire (Mass.) Medical Institu- 
tion, and commenced practice in Ohio upon Allopathic principles. Becoming dis- 
gusted with the result of his labors, he sought means of relief for the sick in 
Thomsonism, in Homoeopathy and Hydropathy. At the time of the establishment 
of the Eclectic Medical Institute of Cincinnati., in 1840, Dr. Paine was among its 
students and supporters. Here he received a diploma, and has since been engaged 
in a very extensive and lucrative practice. In 1856, he was elected to the chair of 
Theory and Practice in the College, in which he now gives his agreeable and 
instructive lectures. He strenuously refuses to submit to the ipse dixit of any sect 
in medicine, and seems to have a peculiar tact in selecting from all the schools 
that only which is really valuable and worthy of retention. He has ample expe- 
rience as a teacher in academies; and, as a public lecturer on political and scientific 
topics, has very few equals or superiors." 

Dr. J. B. Holland has recently been elected to his chair in this Institution. He 
has long been one of the most successful teachers of scientific subjects New England 
afforis, and has received the degree of A. M. from Amherst College, Mass. He 
comes to us from the Medical Department of Dartmouth, N. H., where he has long- 
been devoting especial attention to his chair of instruction. The Institution is 
fortunate in securing the services of one so eminently qualified to fill, with honor 
to himself and the Institution, the chair of Anatomy and Physiology. 

The advantages which Philadelphia affords to the student of medicine are un- 
surpassed by any city on the Continent. The hospitals, which are of the finest 
character, being accessible on the same terms to the students of all medical insti- 
tutions. 

FEES. 

Matriculation Ticket (paid on the first session only) $ 5 00 

Course of Lectures (six professors) 48 00 

Graduation and Diploma 25 00 

Demonstrators Fee 5 00 

The requirements for Graduation are three years' study, good moral character, a 
competent literary education, attendance on two courses of medical lectures, one 
of which must have been in this college, and the sustaining of a thorough ex- 
amination by the Faculty, and the writing and defense, before the Faculty, of a 
Thesis, upon some medical subject. 

Students, on arriving in the city, should call on the Dean at his residence, No. 
913 Race street — also found in the City Directory. For further information, address 

MARSHALL CALKINS, M. D., No. 913 Race street, Philadelphia. 



Will be Published, October 1st, 1857, by 

H. COWPERTHWAIT & CO., 

THORACIC DISEASES: 

THEIR PATHOLOGY, DIAGNOSIS, AND TREATMENT. 

BY 

CALVIN NEWTON, A. M., M. D., and MARSHALL CALKINS, A. M., M. D. 
SECOND EDITION, 

REVISED AND GREATLY ENLARGED. 

Containing a full description of the modern improvements in treatment, 
and of the Eclectic Concentrated Remedies, and their application, to 
the removal of Pulmonary and Cardiac Affections. The work will con- 
tain over five hundred octavo pages, printed on good paper, and hand- 
somely bound. Price, in cloth, $2.75; in sheep, $3. 

TESTIMONIALS. 

{t A most valuable contribution to our Medical literature, which should be on the 
shelf of every practitioner." A. R. THOMAS, M. D., 

Professor of Anatomy in Penn Medical University. 



"Prof. Calkins — Dear Sir: I have read with unusual interest the very original 
and lucid work on Thoracic Diseases, commenced by the late Prof. C. Newton, and 
finished by yourself. A more able and valuable work has never been published. I 
say this from having perused nearly every work on the subject, written by the 
most eminent physiologists and pathologists of the age. It is complete and satis- 
factory, particularly in regard to the pathology of the various diseases of the throat 
and chest, and their treatment. It should be in the library of every practitioner 
of philanthropic and liberal principles. It can be read with the greatest pleasure 
and benefit by all intelligent laymen. It ought to be universally read, and doubt- 
less will be when its remarkable merits are sufficiently made known. I cordially 
commend it to the Profession and the community. 

" With high respect, I am yours, M. HARDIN ANDREWS, M. D., 

"Prof, of Mental Philosophy and Med. Jurisprudence in Penn Med. University." 

." This is a work of sterling merit, full of knowledge, and rich in both philosophy 
and experience. The whole volume gives evidence of long observation, careful 
thinking, and much experience."— New York Journal of Medical Reform. 



" We cheerfully recommend this work as the very best, on the subjects embraced, 
in the American language; and any medical man who fails to read it must be but 
little desirous- of acquitting himself in the best manner towards his patients or the 
Profession." — Middle States' Medical Reformer, 

(418) 



